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J Knee Surg 2014; 27(05): 327-330
DOI: 10.1055/s-0034-1382812
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Disadvantages and Advantages of Transtibial Technique for Creating the Anterior Cruciate Ligament Femoral Socket

Brett N. Robin
1   Taos Orthopedic Institute, Taos, New Mexico
,
James H. Lubowitz
1   Taos Orthopedic Institute, Taos, New Mexico
› Institutsangaben
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Publikationsverlauf

23. April 2014

01. Mai 2014

Publikationsdatum:
21. Juni 2014 (online)

    Lizenzen und Reprints

Abstract

Anterior cruciate ligament (ACL) femoral socket techniques have distinct advantages and disadvantages when considering the following techniques: transtibial, anteromedial portal, outside-in, and outside-in retroconstruction. There is no one perfect technique and we have an incomplete understanding of anatomical, biomechanical, isometry, stability, and clinical outcomes. Our primary focus is transtibial technique for creating the ACL femoral socket. Advantages include less invasive, isometric graft placement, stable Lachman exam, and minimal graft impingement with the tunnel and notch. Disadvantages include nonanatomic vertical graft placement that can cause rotational instability and positive pivot shift, interference screw divergence, graft-tunnel length mismatch, femoral socket constraint, posterior cruciate ligament impingement, and a short, oblique tibial tunnel that may undermine the medial plateau in an attempt to achieve anatomic ACL reconstruction.

Keywords

knee - ACL - femoral - transtibial - anteromedial portal - outside-in
 

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