Anatomic ACL reconstruction: rectangular tunnel/bone-patellar tendon-bone or triple-bundle/semitendinosus tendon grafting

Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association
Konsei ShinoYuta Tachibana

Abstract

Anatomic ACL reconstruction is the reasonable approach to restore stability without loss of motion after ACL tear. To mimic the normal ACL like a ribbon, our preferred procedures is the anatomic rectangular tunnel (ART) technique with a bone-patellar tendon-bone (BTB) graft or the anatomic triple bundle (ATB) procedure with a hamstring (HS) tendon graft. It is important to create tunnel apertures inside the attachment areas to lessen the tunnel widening. To identify the crescent-shaped ACL femoral attachment area, the upper cartilage margin, the posterior cartilage margin and the resident's ridge are used as landmarks. To delineate the C-shaped tibial insertion, medial intercondylar ridge, Parson's knob and anterior horn of the lateral meniscus are helpful. In ART-BTB procedure which is suitable for male patients engaged in contact sports, the parallelepiped tunnels with rectangular apertures are made within the femoral and tibial attachment areas. In ATB-HS technique which is mainly applied to female athletes engaged in non-contact sports including skiing or basketball, 2 femoral and 3 tibial round tunnels are created inside the attachment areas. These techniques make it possible for the grafts to run as the native ACL without...Continue Reading

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Citations

Jun 3, 2016·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Takayuki Furumatsu, Toshifumi Ozaki
Nov 22, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Yuta TachibanaShigeto Nakagawa
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Aug 26, 2021·Arthroscopy, Sports Medicine, and Rehabilitation·Tomoaki KamiyaToshihiko Yamashita

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