Protection of the Medial Femoral Condyle Articular Cartilage During Drilling of the Femoral Tunnel Through the Accessory Medial Portal in Anatomic Anterior.

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Presentation transcript:

Protection of the Medial Femoral Condyle Articular Cartilage During Drilling of the Femoral Tunnel Through the Accessory Medial Portal in Anatomic Anterior Cruciate Ligament Reconstruction Ashraf Abdelkafy, M.D. Arthroscopy Techniques Volume 1, Issue 2, Pages e149-e154 (December 2012) DOI: 10.1016/j.eats.2012.05.008 Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 1 Articular cartilage injury to the medial femoral condyle caused by the drill bit head during drilling of the femoral tunnel through the AMP in anatomic ACL reconstruction. The guide pin is in the AMP, the arthroscope is in the central portal, and the right knee is flexed 100°, with the patient in the supine position. Arthroscopy Techniques 2012 1, e149-e154DOI: (10.1016/j.eats.2012.05.008) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 2 The guide pin is observed to be very close to the articular cartilage of the medial femoral condyle before drilling of the femoral tunnel through the AMP in anatomic ACL reconstruction. The guide pin is in the AMP, the arthroscope is in the central portal, and the right knee is flexed 100°, with the patient in the supine position. Arthroscopy Techniques 2012 1, e149-e154DOI: (10.1016/j.eats.2012.05.008) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 3 Bio-interference screw sheath that is inserted through the AMP over the guide pin to protect the articular cartilage of the medial femoral condyle from injury by the drill bit head in anatomic ACL reconstruction. Arthroscopy Techniques 2012 1, e149-e154DOI: (10.1016/j.eats.2012.05.008) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 4 A bio-interference screw sheath is inserted through the AMP over the guide pin until it reaches near the medial wall of the lateral femoral condyle, protecting the articular cartilage of the medial femoral condyle, medial meniscus, PCL, and skin of the AMP in anatomic ACL reconstruction. The guide pin and bio-interference screw sheath are in the AMP, the arthroscope is in the central portal, and the right knee is flexed 100°, with the patient in the supine position. Arthroscopy Techniques 2012 1, e149-e154DOI: (10.1016/j.eats.2012.05.008) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions

Figure 5 The appropriately sized drill bit for the femoral tunnel is inserted over the guide pin and through the bio-interference screw sheath to drill the femoral tunnel through the AMP in anatomic ACL reconstruction. The guide pin, bio-interference screw sheath, and drill bit are in the AMP; the arthroscope is in the central portal; and the right knee is flexed 100°, with the patient in the supine position. Arthroscopy Techniques 2012 1, e149-e154DOI: (10.1016/j.eats.2012.05.008) Copyright © 2012 Arthroscopy Association of North America Terms and Conditions