Abstract
Arthroscopic reconstruction of the anterior cruciate ligament (ACL) has the advantage of less morbidity and more detailed observation of the knee joint than conventional open procedures. In this paper, endoscopic technique for ACL reconstruction using patellar tendon autograft is reported.
The problems of endoscopic technique are breakage of femoral cortex, breakage of patellar tendon graft, breakage of guide pin, injury of posterior cruciate ligament, and residual bone tips inside the joint. We describe the solusions of these problems.
1. To avoid the breakage of femoral cortex, it is necessary to check the position of the femoral guide wire in the X-P.
2. To avoid the breakage of patellar tendon graft, we insert the femoral screw coverd with the Penrose drain.
3. To avoid the breakbge of guide pin, we insert the femoral guide wire at 90° knee flexion, and insert the femoral screw at more than 120° knee flexion.
4. To prevent the injury of posterior cruciate ligament, the femoral guide wire should be placed around the “eleven o'clock” in the right knee, and around the “one o'clock” in the left knee.
5. To prevent the residual bone tips inside the joint, it is necessary to irrigate the joint sufficiently.
