Joshi Amit, Basukala Bibek, Singh Nagmani, Bista Rohit, Tripathi Navin, Pradhan Ishor
AKB Center for Arthroscopy, Sports Injury and Regenerative Medicine. Lalitpur, Nepal.
Arthrosc Tech. 2020 Oct 22;9(11):e1837-e1843. doi: 10.1016/j.eats.2020.08.008. eCollection 2020 Nov.
Fixation over bone bridge is commonly performed during transosseous pullout knee surgeries. This technique requires the drilling of 2 bony tunnels separately. Herein, we describe our technique in which bone bridge fixation is performed with a single bony tunnel. Our technique is described in 4 simple steps. Step 1: A short accessory tunnel is created from a point at least 1 cm away from the aperture of primary bone tunnel and opening into the lumen of the primary tunnel. Step 2: A shuttle suture (PROLENE) loop is passed from the accessory tunnel to the primary tunnel, and the loop is retrieved out of the primary tunnel using an 18-G epidural needle and arthroscopy probe. Step 3: Complimentary limbs of the pullout suture is then shuttled through the accessory tunnel using shuttle suture loop. Step 4: The knots are tied over the intervening bone bridge. Since the sutures are tied over the bone bridge, it has to be strong enough to provide support. This method of fixation is contraindicated when there is severe osteoporosis or if the tunnels are located in metaphysis. A supplemental video demonstration of the technique is included with this article.
在经骨拔出式膝关节手术中，通常会进行骨桥固定。该技术需要分别钻两个骨隧道。在此，我们描述一种通过单个骨隧道进行骨桥固定的技术。我们的技术按4个简单步骤进行描述。步骤1：从距主骨隧道开口至少1厘米处的一点创建一个短的辅助隧道，并通向主隧道的管腔。步骤2：将一个穿梭缝线（普理灵）环从辅助隧道穿过至主隧道，并使用18G硬膜外穿刺针和关节镜探头将该环从主隧道中取出。步骤3：然后使用穿梭缝线环将拔出缝线的互补肢体穿过辅助隧道。步骤4：在中间的骨桥上打结。由于缝线是在骨桥上打结，因此骨桥必须足够坚固以提供支撑。当存在严重骨质疏松症或隧道位于干骺端时，这种固定方法是禁忌的。本文包含该技术的补充视频演示。
