Transtibial tubercle fixation without hardware for anterior cruciate ligament and posterior cruciate ligament reconstruction: A new technique

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
Charles B Pasque, Scott de la Garza

Abstract

Tibial fixation with implants for both anterior and posterior cruciate ligament reconstructions (ACLR and PCLR) can be associated with a wide variety of problems. Common problems encountered include graft-tunnel mismatch when using grafts with bone blocks, graft damage or poor graft fixation using metal or absorbable implants, painful retained hardware requiring removal, and hardware interference during revision surgery. A new technique is presented using transosseous graft suture passage across the tibial tubercle followed by knot tying over a bone bridge. The technique provides a quick, simple, safe, and reproducible alternative for primary or supplemental tibial graft fixation without hardware in ACLR and PCLR.

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