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Review
. 2017 Oct 31:11:1154-1164.
doi: 10.2174/1874325001711011154. eCollection 2017.

Anatomic Outside-In Reconstruction of the Anterior Cruciate Ligament Using Femoral Fixation with Metallic Interference Screw and Surgical Staples (Agrafe) in the Tibia: An Effective Low-Cost Technique

Ariel de Lima Diego  1   2 , de Vasconcelos Stemberg Martins  1   3 , Leite José Alberto Dias  2 , Pinto Dilamar Moreira  1 , Teixeira Rogério Beltrão  1 , de Léo Álvaro Coelho  1 , Silveira Leonardo de Lima  1   3 , Gonçalves Romeu Krause  1 , Gonçalves Marcelo Carvalho Krause  1 , de Vasconcelos Ana Carolina Leite  1 , Filho Carlos Frederico Dias Costa  1 , de Lima Lana Lacerda  2
Affiliations
Review

Anatomic Outside-In Reconstruction of the Anterior Cruciate Ligament Using Femoral Fixation with Metallic Interference Screw and Surgical Staples (Agrafe) in the Tibia: An Effective Low-Cost Technique

Ariel de Lima Diego et al. Open Orthop J. .

Abstract

Background: An anterior cruciate ligament (ACL) rupture is a frequent injury, with short and long-term consequences if left untreated. With a view to benefitting as many patients as possible and preventing future complications, we created a low-cost ligament reconstruction technique.

Method: The present article describes an anatomic ACL reconstruction technique.

Results: The technique involves single-band reconstruction, using flexors tendon graft, outside-in tunnel perforation, femoral fixation with metal interference screw and surgical staples (Agrafe) in the longitudinal position.

Conclusion: We present a simple, easy-to-reproduce technique that, when executed on patients with good bone quality, primarily in the tibia, is effective and inexpensive, favoring its large scale application.

Keywords: Agrafe; Anterior Cruciate Ligament; Interference Screw; Low-cost; Reconstruction; Surgical Staple.

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Figures

Fig. (1)
Fig. (1)
Metallic interference screw and surgical staple (Agrafe).
Fig. (2)
Fig. (2)
Patient's position.
Fig. (3)
Fig. (3)
Incision for removal of the flexors graft.
Fig. (4)
Fig. (4)
Quadruple flexor tendon graft.
Fig. (5)
Fig. (5)
Quadruple flexor tendon graft.
Fig. (6)
Fig. (6)
Outside-in guide.
Fig. (7)
Fig. (7)
The center of the femoral tunnel.
Fig. (8)
Fig. (8)
Femoral tunnel.
Fig. (9)
Fig. (9)
Tibial tunnel.
Fig. (10)
Fig. (10)
Knee flexion-extension.
Fig. (11)
Fig. (11)
Introduction of the graft.
Fig. (12)
Fig. (12)
Tibial fixation with Agrafe in the longitudinal position, anchoring the graft loop.
Fig. (13)
Fig. (13)
Tibial fixation with Agrafe in the longitudinal position, anchoring the graft loop.
Fig. (14)
Fig. (14)
Femoral fixation with metallic interference screw.
Fig. (15)
Fig. (15)
Postoperative radiography.
Fig. (16)
Fig. (16)
One of the “legs” of the Agrafe is inside the graft loop, functioning as a post.
See this image and copyright information in PMC

References

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