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Chap. 15 Video 11: Anatomic Single Bundle ACL Reconstruction without Roof and PCL Impingement - Tibialis Allograft

February 05, 2016

Contributors: Stephen M Howell, MD; Oscar Andres, MD

This video demonstrates a single bundle ACL reconstruction with a tibialis allograft and the important steps to avoid roof and PCL impingement. Portals are made at the joint line at the medial edge of the patellar tendon and at the approximate midline of the patellar tendon. A 65° guide is used to gauge the space between the lateral femoral condyle and the PCL; this space is too narrow, so a wallplasty is performed. The femoral tunnel drill point should be halfway between the apex and the bottom of the intercondylar notch. The sagittal trajectory is aimed to avoid roof impingement, and the coronal trajectory is aimed to avoid PCL impingement. The tunnels are reamed and the graft passed.The knee is cycled 15-20 times, and the tibial end is fixed in full extension. The desirable triangular space between the PCL and the graft is demonstrated.

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