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Anterior Cruciate Ligament Femoral Socket Preparation Using a Cannulated, Calibrated Drill With Adjustable Stop and Slotted Cannula.

ABSTRACT: Anteromedial portal-guided femoral tunnel preparation during anterior cruciate ligament reconstruction can be difficult owing to poor visualization. This may cause iatrogenic damage to the medial femoral condyle cartilage and the posterior cruciate ligament fibers or overdrilling through the lateral femoral cortex, creating difficulties in the use of femoral suspensory devices during anterior cruciate ligament reconstruction. We describe an accurate and safe technique for femoral graft socket preparation using a cannulated, calibrated drill with an adjustable stop and slotted cannula. This easy and reproducible technique uses simple additional instruments and effectively addresses concerns related to femoral graft socket preparation, without requiring additional surgical time.

SUBMITTER: Patwardhan AR

PROVIDER: S-EPMC7917199 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Anterior Cruciate Ligament Femoral Socket Preparation Using a Cannulated, Calibrated Drill With Adjustable Stop and Slotted Cannula.

Patwardhan Apoorva R AR Kandhari Vikram K VK

Arthroscopy techniques 20210128 2

Anteromedial portal-guided femoral tunnel preparation during anterior cruciate ligament reconstruction can be difficult owing to poor visualization. This may cause iatrogenic damage to the medial femoral condyle cartilage and the posterior cruciate ligament fibers or overdrilling through the lateral femoral cortex, creating difficulties in the use of femoral suspensory devices during anterior cruciate ligament reconstruction. We describe an accurate and safe technique for femoral graft socket pr ...[more]

PMID: 33680772

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Commercially Available Guides Overestimate Socket Length During Anterior and Posterior Cruciate Ligament Socket Retrograde Drilling.

Project description:PurposeTo objectively assess the accuracy of socket measurements taken during cruciate ligament reconstruction using a retrograde reaming technique.MethodsSix complete knee sawbone specimens were used to ream anterior and posterior cruciate ligament sockets in the femur and tibia in a retrograde fashion using a standard retrograde reaming device. The longest and shortest sides of the sockets were measured using a ruler. One-sided Wilcoxon signed-rank sum tests were used to evaluate whether the actual measured socket length matched the estimated length set on the drill guide.ResultsOne fellowship-trained surgeon reamed 24 total sockets in sawbone specimens using guides. Statistical analysis revealed a significant difference between the estimated measurement and the actual shortest tunnel length in each of the sockets. The median short side socket lengths were shorter than their respective intended depths by 4 mm for the femoral anterior cruciate ligament socket, 6 mm for the femoral posterior cruciate ligament socket, 6 mm for the tibial anterior cruciate ligament socket, and 4.5 mm for the tibial posterior cruciate ligament socket. All differences were significant at α = 0.05.ConclusionsThe estimated cruciate socket lengths reamed during ligament reconstruction using a retrograde reamer and standard intra-articular measuring instrumentation were greater than the actual measured socket lengths.Clinical relevanceSuccessful cruciate ligament reconstruction relies on accurate socket measurements. This study examined the accuracy of commercially available cruciate ligament socket drill guides and the implications for clinical practice, to include graft-tunnel mismatch and surface area available for healing. Surgeons may consider reaming slightly longer than estimated sockets when performing all-inside cruciate ligament reconstructions to ensure appropriate socket depth for graft fixation.

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Fully-threaded cannulated screws versus partially-threaded cannulated screws for femoral neck fractures: a systematic review and meta-analysis.

Project description:ObjectiveFemoral neck fractures (FNFs) are a common orthopedic type, and there are many treatment methods for it, and cannulated screw internal fixation is currently one of the main treatment methods. The choice of fully threaded cannulated screw (FCS) or partially threaded cannulated screw (PCS) remains controversial. Therefore, we performed this meta-analysis to evaluate the outcomes of FCS and PCS in the treatment of FNF.MethodsArticles published before 29 April, 2024 were selected from PubMed, Embase, the Cochrane Library, and CNKI, using the PRISMA guidelines. Two independent reviewers searched and assessed the literature. The PICOS criteria were used to ensure that the included studies met the inclusion criteria. We used RevMan 5.3. Software to perform analysis.ResultsCompared with the PCS group, the FCS group had a lower femoral head necrosis rate (OR 0.60, 95% CI 0.37-0.98, P = 0.04), lower internal fixation failure rate (OR 0.37, 95% CI 0.22-0.62, P = 0.0002) and lower femoral neck shortening rate (OR 0.27, 95% CI 0.19-0.40, P < 0.00001). There was no statistically significant difference between the two groups in terms of the Harris hip score or nonunion rate.ConclusionsThe results of this meta-analysis revealed that compared with PCS, FCS had a lower incidence of postoperative complications and better postoperative outcomes in the treatment of FNF. Therefore, we believe that FCS may be a more effective treatment for FNF.

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