LIVRE JDG 2016

139

PATIENT POSITIONING

(fig. 1)

• Operating room table kept flat,

• Padded lateral thigh post,

• Padded lateral hip positioner,

• 2 padded L-shaped foot supports.

THREE PORTALTECHNIQUE

FOR ANATOMIC

SINGLE-BUNDLE ACL

RECONSTRUCTION

Anatomic ACL reconstruction (ACLR) has tra

ditionally been performed using 2 arthroscopic

portals, the anterolateral (AL) and the

anteromedial (AM) portals. Limitations of the

2 portal approach include the following:

• The lateral wall of the intercondylar notch is

viewed through the AL portal resulting in a

tangential view of the ACL femoral

attachment site which can potentially

compromise the surgeon’s ability to accurately

place the ACL femoral tunnel within the

native ACL femoral attachment site;

• Drilling the ACL femoral tunnel through the

AM portal can result in shorter femoral tunnel

lengths, limiting the length of the ACL graft

that can be inserted into the ACL femoral

tunnel when cortical suspensory fixation

devices are used.

SINGLE-BUNDLE ACL

RECONSTRUCTION: HOW I DO IT

C.H. BROWN

Fig. 1:

Patient positioning. (a) Patient’s pelvis and torso is stabilized on the operating room table by a

padded lateral hip positioner and padded thigh post. (b) The distal foot support is secured to the side rail of

the operating room table near the end of the table. The patient’s torso is moved down the table until the

knee is maintained at 90 degrees of knee flexion. (c) The proximal foot support is adjusted to maintain the

knee in hyperflexion during drilling of the ACL femoral tunnel. (d) The height of the proximal and distal foot

supports can be adjusted to maintain the desired degree of flexion during ACL graft tensioning and fixation.