Lee Dhong Won, Kim Jin Goo
Department of Orthopaedic Surgery, Armed Forces Daejeon Hospital, Daejeon, Republic of Korea.
Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul, Republic of Korea.
Arthrosc Tech. 2017 Feb 20;6(1):e227-e232. doi: 10.1016/j.eats.2016.09.028. eCollection 2017 Feb.
We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with a modified transtibial technique. Our modified transtibial technique has the advantages of the conventional transtibial technique that is familiar to surgeons and that allows the press-fit fixing and enables us to make a relatively long femoral tunnel. To make the femoral tunnel at the anatomic position, the triangular, funnel-shaped bony trough was made to slip the eccentrically positioned guide pin into the anticipated anatomic center with a free-hand technique after marking the anatomic ACL footprint using a microfracture awl through the anteromedial portal. Gradual femoral reaming was performed with knee angle changes, which reduces the chances of posterior wall blowout, increases the femoral tunnel length, and avoids breakage of guide pin at the bending point. Our modified transtibial technique is anticipated to provide a more anatomic placement of the femoral tunnel during ACL reconstruction than the previous traditional transtibial techniques.
我们介绍一种使用自体腘绳肌腱并采用改良经胫骨技术进行前交叉韧带（ACL）重建的技术。我们的改良经胫骨技术具有传统经胫骨技术的优点，外科医生对该技术较为熟悉，它允许压配固定，并且使我们能够制作相对较长的股骨隧道。为了在解剖位置制作股骨隧道，在使用微型骨折锥通过前内侧入路标记解剖学ACL足迹后，采用徒手技术制作三角形、漏斗形骨槽，以使偏心定位的导针滑入预期的解剖学中心。随着膝关节角度变化进行逐步股骨扩孔，这减少了后壁爆裂的机会，增加了股骨隧道长度，并避免导针在弯曲点处断裂。预计我们的改良经胫骨技术在ACL重建过程中比以往的传统经胫骨技术能提供更符合解剖学的股骨隧道放置。
