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B. SONNERY-COTTET, R. ZAYNI
50
Isolated ALL reconstruction
[20]
The gracilis tendon is used as a graft. Two
K-wires are inserted through two, less than
1-cm long skin incisions: one on the posterior
edge of Gerdy’s tubercle and one anterior to the
fibular head. A third K-wire is placed posterior
and proximal to the epicondyle. A suture is used
to ensure that the distance between these three
points differs when the knee is moved – theALL
must be tight in extension and slack in flexion.
After the isometry has been checked, 6 x 20mm
tunnels are made in the femur and tibia.
The gracilis graft is secured to the femur using
a 5.5-mm suture anchor (SwiveLock®,
Arthrex). The two distal ends are retrieved
subcutaneously through the distal incisions,
making sure they pass under the fascia lata.
Tibial fixation of the two strands is carried out
with the knee fully extended to avoid fixation
in external rotation.