ACL Imaging Syllabus
2014-02-26
: Pdf Acl Imaging Syllabus ACL_Imaging_Syllabus 2 2014 pdf
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Page Count: 51
- Can flexible Reamers Improve Access to theFemoral Insertion Site ACL Imaging & Reconstruction Webinar2014Mark E. Steiner, MDNew England Baptist HospitalBoston
- Disclosures
- Failures of ACL Reconstruction
- One vs Two Bundle ACLSB = DB with AM Drilling (not with TT Drilling)
- Biomechanics of Anatomic SB vs DB– Ho, Arthroscopy ‘09
- SB Centered (Anatomic) in ACL Footprint = DB
- Anatomic Transtibial DrillingTibial or Femoral Tunnels have to be compromised
- Does it Matter if the Tibial or Femoral tunnel is Compromised
- Trying to Find an Anatomic ACLView of the Notch Varies
- Problem with Clock FaceToo much variability
- Finding the ACL FootprintIntercondylar and bifurcate Ridges
- Measurements to the ACL Center at 90° flexion
- Flexible Reamers = Reconstruction in 90° Flexion
- AM Aimer at Height of ACL→ Point just deep to ACL
- Enlarge Pilot Hole with the Awl
- Aimer Placed Through AM PortalPin Positioned in Starter Hole
- Guidepin Placement
- Advance Flexible Reamer Over Pin
- Tunnels ≈ 40 mm Length
- Tunnel low at 90° = Tunnel posterior at 20°
- Nitinol Pin Creates a Straight Tunnel
- Interference Screw Fixation with Flexible Screwdriverat 90°
- Biomechanics of Aperture vs Suspensory Fixation
- Anatomic Nonimpinging Graft
- Keep It Anatomic