Navigated intra-articular ACL reconstruction with additional extra-articular tenodesis using the same hamstring graft.

Abstract

In some complex cases, standard anterior cruciate ligament reconstruction is not enough and could lead to a new failure. Lateral extra-articular reconstruction should be added. We describe a new mini-invasive technique using the same hamstring graft for intra-articular reconstruction and lateral tenodesis, optimized with navigation. This arthroscopic technique is precisely described, different graft setting are possible, four strands graft inside the joint and two strands for the tenodesis or two strands graft for all the whole graft. As the lateral tenodesis is not anatomic, tunnel placement could be tricky. The use of navigation system is a real advantage for this technique with optimal tunnels placement. No results are given. This technique is comparable to others reported previously, showing a clinical advantage and no increasing of osteoarthritis. The use of the same graft avoids collateral damages, and navigation improves the graft placement.