Revision Posterior Cruciate Ligament Reconstruction with a Modified Tibial-Inlay Double-Bundle Technique by Sang Hak Lee, Young-Bok Jung, Sung-Min Rhee,

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Presentation transcript:

Revision Posterior Cruciate Ligament Reconstruction with a Modified Tibial-Inlay Double-Bundle Technique by Sang Hak Lee, Young-Bok Jung, Sung-Min Rhee, Han-Jun Lee, and Ho-Joong Jung JBJS Essent Surg Tech Volume 4(1):e1 January 8, 2014 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

The Achilles tendon allograft consists of a tibial bone block and two tendon tails secured with a locking whipstitch with number-5 nonabsorbable suture. The Achilles tendon allograft consists of a tibial bone block and two tendon tails secured with a locking whipstitch with number-5 nonabsorbable suture. Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

The center of the anterolateral femoral tunnel is placed 5 to 6 mm proximal to the articular cartilage at the one o’clock position. The center of the anterolateral femoral tunnel is placed 5 to 6 mm proximal to the articular cartilage at the one o’clock position. The posteromedial tunnel is placed 8 to 9 mm proximal to the margin of the distal articular cartilage, at the 3 o’clock position in a right knee. MFC = medial femoral condyle, and LFC = lateral femoral condyle. Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

The operating table is tilted down on the affected side for the posterior approach. Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

The medial border of the medial head of the gastrocnemius muscle is identified, and the interval between it and the semimembranosus tendon is developed, exposing the posterior aspect of the joint capsule. The medial border of the medial head of the gastrocnemius muscle is identified, and the interval between it and the semimembranosus tendon is developed, exposing the posterior aspect of the joint capsule. Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

The bone block of the tibial attachment site of the PCL is detached with use of a curved osteotome, and a trough is created. The bone block of the tibial attachment site of the PCL is detached with use of a curved osteotome, and a trough is created. Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.

A 6.5-mm cannulated screw and a spiked washer are used to fix the graft to the tibia. Sang Hak Lee et al. JBJS Essent Surg Tech 2014;4:e1 ©2014 by The Journal of Bone and Joint Surgery, Inc.