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Chap. 15 Video 6: Anatomical Rectangular Tunnel ACL Reconstruction Using BTB Graft

February 05, 2016

Contributors: Konsei Shino, MD

Three benefits of this procedure are outlined: that it uses the double bundle concept with a single BTB graft, that is maximizes the graft-tunnel contact area, and that notch anatomy is preserved. Fiber arrangement is demonstrated with a diagram, and the rectangular profile of the graft is overlaid. The graft is harvested and bone plugs shaped. Portals are made: anteromedial, anterolateral, and the far anteromedial. The ACL stump is excised, and attachment points are made. The tibial and femoral tunnel rectangular profiles are demonstrated. The femoral interference screw is introduced with an outside-in technique, then the graft is passed through the tibial and then femoral tunnels. Both ends are fixed, and notch or PCL impingement is not present. Rehabilitation is discussed.

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