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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2011

Open Access 01-08-2011 | Knee

Advances in the three-portal technique for anatomical single- or double-bundle ACL reconstruction

Authors: Paulo H. Araujo, Carola F. van Eck, Jeffrey A. Macalena, Freddie H. Fu

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2011

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Abstract

Purpose

To describe the “three-portal technique for anatomical ACL single- or double-bundle reconstruction” and the arthroscopic viewing improvement provided by this technique.

Methods

A “high” anterolateral portal was placed 1 cm lateral to the patellar tendon and the most inferior portion of the portal at the level of the inferior pole of the patella. A “central” portal was placed using a spinal needle under arthroscopic visualization following the orientation of the previous ACL fibers. An accessory medial portal was also placed using a spinal needle respecting a 2-mm distance to the medial femoral condyle.

Results

The “high” anterolateral portal permitted a broad and unobstructed view of the ACL tibial attachment. The “central” portal allowed a straightforward view of the ACL femoral remnant and bony landmarks in the intercondylar notch. The accessory medial portal enabled to reach the femoral native insertion site of the ACL.

Conclusion

The three-portal technique provides a proper view of the soft tissue remnants and bony landmarks facilitating an anatomical positioning of the graft.
Literature
1.
Schreiber VM, van Eck CF, Fu FH (2010) Anatomic double-bundle ACL reconstruction. Sports Med Arthrosc Rev 18:27–32CrossRef
2.
Bedi A, Altchek DW (2009) The “Footprint” anterior cruciate ligament technique: an anatomic approach to anterior cruciate ligament reconstruction. Arthroscopy 25:1128–1138PubMedCrossRef
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Lohmander LS, Ostenberg A, Englund M, Roos H (2004) High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 50:3145–3152PubMedCrossRef
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Nikolaou VS, Efstathopoulos N, Sourlas I, Pilichou A, Papachristou G (2009) Anatomic double-bundle versus single-bundle ACL reconstruction: a comparative biomechanical study in rabbits. Knee Surg Sports Traumatol Arthrosc 17:895–906PubMedCrossRef
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Snow M, Stanish WD (2010) Double-bundle ACL reconstruction: how big is the learning curve? Knee Surg Sports Traumatol Arthrosc 18:1195–1200PubMedCrossRef
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van Eck CF, Schreiber VM, Liu TT, Fu FH (2010) The anatomic approach to primary, revision and augumentation anterior cruciate ligament rconstruction. Knee Surg Sports Traumatol Arthrosc 18:1154–1163PubMedCrossRef
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Cohen SB, Fu FH (2007) Three-portal technique for anterior cruciate ligament reconstruction: use of a central medial portal. Arthroscopy 23:325.e1–325.e4
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Johnson DL, Swenson TM, Irrgang JJ, Fu FH, Harner CD (1996) Revision anterior cruciate ligament surgery: experience from Pittsburgh. Clin Orthop Relat Res 325:100–109PubMedCrossRef
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Sommer C, Friederich NF, Müller W (2000) Improperly placesanterior cruciate ligament grafts: correlation between radiological parameters and clinical results. Knee Surg Sports Traumatol Arthrosc 8:207–213PubMedCrossRef
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Lubowitz JH (2009) Anteromedial portal technique for the anterior cruciate ligament femoral socket: pitfalls and solutions. Arthroscopy 25:95–101PubMedCrossRef
Metadata
Title
Advances in the three-portal technique for anatomical single- or double-bundle ACL reconstruction
Authors
Paulo H. Araujo
Carola F. van Eck
Jeffrey A. Macalena
Freddie H. Fu
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1426-z

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