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Posterior Wall Blowout During Anterior Cruciate Ligament Reconstruction: Suspensory Cortical Fixation With a Screw and Washer Post  Justin J. Mitchell,

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Presentation on theme: "Posterior Wall Blowout During Anterior Cruciate Ligament Reconstruction: Suspensory Cortical Fixation With a Screw and Washer Post  Justin J. Mitchell,"— Presentation transcript:

1 Posterior Wall Blowout During Anterior Cruciate Ligament Reconstruction: Suspensory Cortical Fixation With a Screw and Washer Post  Justin J. Mitchell, M.D., Jorge Chahla, M.D., Chase S. Dean, M.D., Travis J. Menge, M.D., Alexander R. Vap, M.D., Tyler R. Cram, A.T.C., O.T.C., Robert F. LaPrade, M.D., Ph.D.  Arthroscopy Techniques  Volume 5, Issue 3, Pages e551-e555 (June 2016) DOI: /j.eats Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

2 Fig 1 Violation of the posterior femoral cortex after screw insertion into the femoral tunnel as visualized through the anteromedial arthroscopic portal in a right knee. A representation of posterior wall blowout during anterior cruciate ligament reconstruction is shown in the upper left corner. Arthroscopy Techniques 2016 5, e551-e555DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

3 Fig 2 Anatomic landmarks for the skin incision after a posterior wall violation during anterior cruciate ligament reconstruction in a right knee. A longitudinal incision is performed over the lateral supracondylar ridge. (F, fibula; P, popliteus sulcus.) Arthroscopy Techniques 2016 5, e551-e555DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

4 Fig 3 A longitudinal incision of the iliotibial band (ITB) over the lateral supracondylar ridge in a right knee. (F, fibula; G, Gerdy tubercle.) Arthroscopy Techniques 2016 5, e551-e555DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

5 Fig 4 Previously placed tunnel with the sutures exiting the tunnel in a right knee. The lateral intermuscular septum constitutes an important landmark for placement of the screw and washer. Arthroscopy Techniques 2016 5, e551-e555DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

6 Fig 5 Cortical fixation with the screw and washer and the graft sutures tied beneath the washer in a right knee. (F, fibula; G, Gerdy tubercle; P, popliteus sulcus.) Arthroscopy Techniques 2016 5, e551-e555DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

7 Fig 6 Standard tibial fixation for anterior cruciate ligament reconstruction after the femoral salvage procedure for posterior wall blowout in a right knee. Arthroscopy Techniques 2016 5, e551-e555DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

8 Fig 7 Arthroscopic view of a right knee showing a bone-tendon-bone graft within the femoral tunnel after suspensory cortical fixation after posterior wall blowout. The graft sutures can be seen attached to the femoral bone plug of the anterior cruciate ligament graft and traveling through the remaining femoral tunnel. Arthroscopy Techniques 2016 5, e551-e555DOI: ( /j.eats ) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

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