Journal: JBJS Essential Surgical Techniques
Article Title: All-Inside, All-Epiphyseal Autograft Reconstruction of the Anterior Cruciate Ligament in the Skeletally Immature Athlete
doi: 10.2106/JBJS.ST.M.00017
Figure Lengend Snippet: Graft preparation. The four-strand autograft is created by looping the two tendons through the attachable button system loop (ABS) and then passing all four strands back through the reverse-tensioning button loop (RT). A FiberLoop is used in a whipstitch to combine the four tendon ends (arrowhead) (Fig. 2-A). The tail of the whipstitch is then passed through the looped tendon in order to bury the end (Fig. 2-B). The graft is then placed in 20 lb (89 N) of tension (Fig. 2-C). A number-0 FiberWire (Arthrex) is passed from inside-out (Fig. 2-D), looped twice around the graft, and passed from outside-in (Fig. 2-E). The knot is tied and laid inside the graft (Fig. 2-F) and is passed again from inside-out, which buries the knot (Fig. 2-G). This is repeated so that four sutures are placed in the tendon, two at each end at 15 mm (arrows) and 20 mm (arrowheads) from the end of the implant strands (Fig. 2-H).
Article Snippet: Using a number-0 FiberWire (Arthrex) and a “buried knot” technique ( Video 1 ), suture the graft limbs together (Fig. ).
Techniques: