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Alternative for tibial fixation in Patellar Tendon ACL Reconstruction

MOJ Orthopedics & Rheumatology
Sergio Mainine MD PhD,1 Filipe Leal Amorim MD,1 Henrique VR de Queiroz MD,1 Rodrigo Arana Meira MD2

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  1. Objective:Introduce an alternative for tibial fixation in Anterior Cruciate Ligament (ACL) with Patellar Tendon, in cases with long graft and a bone plug that stay outside the tibial tunnel and evaluate its results.
  2. Methods: From 2010 to 2020, 12 patients were submitted to a ACL reconstruction with a Bone-Patellar Tendon-Bone (BTB) graft using the anatomic technique. Starting with the femoral fixation, if the BTB graft is too long where the bone plug is outside the tibial tunnel, instead of cutting the graft, a cavity is dig in the tibia, distal to the tunnel entrance, and the bone plug is kept inside using a bone clip, followed by an interference screw in the tibial tunnel. With a minimum follow-up of 24 months, the patients knee stability was evaluated pre and post operatively.
  3. Results:The mean follow up was 29 months. All patients had a stable knee post operatively, with no complications.
  4. Conclusion:The ACL reconstruction using the proposed technique shown excellent results in short and long term, regarding knee stability. We believe that the proposed method is better than just cutting out the bone plug.


Anterior cruciate ligament, patellar tendon, reconstruction, graft