Endoscopic Harvest of Autogenous Gracilis and Semitendinosus Tendons

Slides:



Advertisements
Similar presentations
Open Repair of Quadriceps Tendon With Suture Anchors and Semitendinosus Tendon Allograft Augmentation  Jorge Chahla, M.D., Ph.D., Nicholas N. DePhillipo,
Advertisements

Benjamin F. Donohue, M. D. , M. B. A. , Marc G. Lubitz, B. S
Reconstruction of the Medial Patellofemoral Ligament
Free Bone Plug Quadriceps Tendon Harvest and Suspensory Button Attachment for Anterior Cruciate Ligament Reconstruction  Adrian Todor, M.D., Ph.D., Sergiu.
Alexander Haupert, M.D., Olaf Lorbach, M.D., Ph.D. 
Gregory A. Sawyer, M. D. , Tyler Cram, M. A. , A. T. C. , O. T. C
Surgical Management of Proximal Tibiofibular Joint Instability Using an Adjustable Loop, Cortical Fixation Device  William J. McNamara, M.D., Andrew P.
Combined Reconstruction of the Medial Collateral Ligament and Anterior Cruciate Ligament Using Ipsilateral Quadriceps Tendon–Bone and Bone–Patellar Tendon–Bone.
Anterolateral Extra-articular Soft Tissue Reconstruction in Anterolateral Rotatory Instability of the Knee  Willem A. Kernkamp, M.D., Samuel K. van de.
“The Superficial Quad Technique” for Medial Patellofemoral Ligament Reconstruction: The Surgical Video Technique  Deepak Goyal, M.B.B.S., M.S.(Orthop),
Minimally Invasive Combined Anterior and Anterolateral Stabilization of the Knee Using Hamstring Tendons and Adjustable-Loop Suspensory Fixation Device:
A Modified Osteotomy for Anteromedialization of the Tibial Tubercle
Treatment of Instability of the Proximal Tibiofibular Joint by Dynamic Internal Fixation With a Suture Button  Mads Oksum, M.D., Per-Henrik Randsborg,
Posterior Surgical Approach to the Knee
Shu Kobayashi, M. D. , Ph. D. , Kengo Harato, M. D. , Ph. D
Philippe Colombet, M.D., Nicolas Graveleau, M.D. 
Minimally Invasive Harvest of a Quadriceps Tendon Graft With or Without a Bone Block  Christian Fink, M.D., Mirco Herbort, M.D., Elisabeth Abermann, M.D.,
James H. Lubowitz, M.D., Gordon MacKay, M.D., Brian Gilmer, M.D. 
Multiligament Reconstruction of the Knee in the Setting of Knee Dislocation With a Medial-Sided Injury  Marcio B. Ferrari, M.D., Jorge Chahla, M.D., Justin.
Endoscopic Proximal Hamstring Repair and Ischial Bursectomy
Eric J. Cotter, B. S. , Rachel M. Frank, M. D. , Brian R. Waterman, M
Alexander Haupert, M.D., Olaf Lorbach, M.D., Ph.D. 
Arthroscopic-Assisted Lower Trapezius Tendon Transfer for Massive Irreparable Posterior-Superior Rotator Cuff Tears: Surgical Technique  Bassem T. Elhassan,
Inside-Out Meniscal Repair: Medial and Lateral Approach
Pramod B. Voleti, M. D. , Drake G. Lebrun, B. S. , Cameron A. Roth, B
Ahmad M. Wagih, M.D., M.R.C.S., F.E.O.B., Ahmed M.F. Elguindy, M.D. 
Assem Mohamed Noureldin Zein, M. D. , Mohamed Elshafie, M. D
Assem Mohamed Noureldin Zein, M. D. , Mohamed Ali, M. D
Combined Anatomic Reconstruction of the Anterior Cruciate and Anterolateral Ligaments Using Hamstring Graft Through a Single Femoral Tunnel and With a.
Minimally Invasive Posterior Hamstring Harvest
Graft Preparation Technique to Optimize Hamstring Graft Diameter for Anterior Cruciate Ligament Reconstruction  Brett Fritsch, M.D., Francisco Figueroa,
Avoiding Graft-Tunnel Length Mismatch in Anterior Cruciate Ligament Reconstruction: The Single–Bone Plug Technique  Brian Grawe, M.D., Amber Smerina,
Superficial Medial Collateral Ligament of the Knee: Anatomic Augmentation With Semitendinosus and Gracilis Tendon Autografts  Raphael Serra Cruz, M.D.,
Arthroscopic-Assisted Lower Trapezius Tendon Transfer for Massive Irreparable Posterior-Superior Rotator Cuff Tears: Surgical Technique  Bassem T. Elhassan,
Minimally Invasive Quadriceps Tendon Harvest and Graft Preparation for All-Inside Anterior Cruciate Ligament Reconstruction  Harris S. Slone, M.D., William.
Distal Knee Medial Collateral Ligament Repair With Suture Augmentation
ACL Reconstruction Basics: Quadruple (4-Strand) Hamstring Autograft Harvest  Rachel M. Frank, M.D., Jason T. Hamamoto, B.S., Eamon Bernardoni, B.A., Gregory.
Mosaicplasty Using Grafts From the Upper Tibiofibular Joint
Combined Anterior Cruciate Ligament, Medial Collateral Ligament, and Posterior Oblique Ligament Reconstruction Through Single Tibial Tunnel Using Hamstring.
Pierre Imbert, M. D. , Philippe D'Ingrado, M. D. , Maxime Cavalier, M
Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With a Free Quadriceps Tendon Autograft  Sergiu Caterev, M.D., Dan Viorel Nistor, M.D.,
Anatomic Outside-In Anterior Cruciate Ligament Reconstruction Using a Suspension Device for Femoral Fixation  Alejandro Espejo-Baena, M.D., Alejandro.
Combined Anterior Cruciate Ligament and Posterolateral Corner Reconstruction by Hamstring Tendon Autografts Through a Single Femoral Tunnel by Graft-to-Graft.
Kunbo Park, M. D. , Christopher M. Brusalis, B. A. , Theodore J
James D. Wylie, M.D., M.H.S., Robert T. Burks, M.D. 
Medial Patellofemoral Ligament Reconstruction in a Revision Setting: Anchor and Interference Screw Fixation  Marcio B. Ferrari, M.D., George Sanchez,
Intra-articular Anterior Cruciate Ligament Reconstruction With Extra-articular Lateral Tenodesis of the Iliotibial Band  João Luiz Ellera Gomes, M.D.,
An Anterior Cruciate Ligament Reconstruction Technique With 4-Strand Semitendinosus Grafts, Using Outside-In Tibial Tunnel Drilling and Suspensory Fixation.
Anatomical Arthroscopic Anterior Talofibular Ligament and Calcaneofibular Ligament Reconstruction Using an Autogenic Hamstring Tendon: Safe Creation of.
Pierre Imbert, M. D. , Philippe D'Ingrado, M. D. , Maxime Cavalier, M
Anne Jonkergouw, M. D. , Jelle P. van der List, M. D. , Gregory S
Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft through Single Femoral Tunnel and Single Branched Tibial.
Endoscopic Fasciotomy of the Superficial and Deep Posterior Compartments of the Leg  Tun Hing Lui, M.B.B.S.(H.K.), F.R.C.S.(Edin.), F.H.K.A.M., F.H.K.C.O.S. 
Michael Saper, D.O.  Arthroscopy Techniques 
Kyle P. Lavery, M. D. , Michael Bernazzani, B. S. , Kevin McHale, M. D
Minimally Invasive Quadriceps Tendon Harvest and Graft Preparation for All-Inside Anterior Cruciate Ligament Reconstruction  Harris S. Slone, M.D., William.
Krzysztof Hermanowicz, M. D. , Ph. D. , Konrad Malinowski, M. D. , Ph
Shu Kobayashi, M. D. , Ph. D. , Kengo Harato, M. D. , Ph. D
Julio Cesar Gali, M. D. , Ph. D. , Bárbara Lívia C. Serafim, M. S
Combined Soft Tissue Reconstruction of the Medial Patellofemoral Ligament and Medial Quadriceps Tendon–Femoral Ligament  João Espregueira-Mendes, M.D.,
Philippe Colombet, M.D., Nicolas Graveleau, M.D. 
Konrad Malinowski, M. D. , Ph. D. , Krzysztof Hermanowicz, M. D. , Ph
Primary Repair of the Medial Collateral Ligament with a Double Row Suture Technique and Suture Tape Augmentation for Acute Tibial-Sided Injuries  Thomas.
Savan D. Patel, M. D. , Peter J. Boxley, B. A. , Richard W. Kang, M. S
Superficial Medial Collateral Ligament of the Knee: Anatomic Augmentation With Semitendinosus and Gracilis Tendon Autografts  Raphael Serra Cruz, M.D.,
Combined Reconstruction of the Medial Collateral Ligament and Anterior Cruciate Ligament Using Ipsilateral Quadriceps Tendon–Bone and Bone–Patellar Tendon–Bone.
Endoscopic Fasciotomy of the Superficial and Deep Posterior Compartments of the Leg  Tun Hing Lui, M.B.B.S.(H.K.), F.R.C.S.(Edin.), F.H.K.A.M., F.H.K.C.O.S. 
Kyle P. Lavery, M. D. , Michael Bernazzani, B. S. , Kevin McHale, M. D
“The Superficial Quad Technique” for Medial Patellofemoral Ligament Reconstruction: The Surgical Video Technique  Deepak Goyal, M.B.B.S., M.S.(Orthop),
Assem Mohamed Noureldin Zein, M. D. , Mohamed Ali, M. D
Presentation transcript:

Endoscopic Harvest of Autogenous Gracilis and Semitendinosus Tendons Wen-Ling Yeh, M.D., Ph.D., Jian-Ming Chen, M.D., Chang-Heng Liu, M.D., Ping-Jui Tsai, M.D., Reiji Higashiyama, M.D., Ph.D., Masashi Takaso, M.D., Ph.D.  Arthroscopy Techniques  Volume 7, Issue 10, Pages e1019-e1024 (October 2018) DOI: 10.1016/j.eats.2018.06.007 Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 1 Tools. A, small retractor; B, forceps; C, curved pean; D, curved Kelly forceps; E, Metzenbaum scissors; F, curved mosquito forceps, G, closed tendon stripper. Arthroscopy Techniques 2018 7, e1019-e1024DOI: (10.1016/j.eats.2018.06.007) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 2 Intraoperative photograph (right knee) showing the location and size of the skin incision used for the endoscopic harvest of the gracilis and semitendinosus tendons. The patient is in the supine position. The operative leg is positioned with a leg holder to keep the thigh horizontal. Arthroscopy Techniques 2018 7, e1019-e1024DOI: (10.1016/j.eats.2018.06.007) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 3 A 30° 4-mm diameter arthroscope is then introduced into the space between the superficial medial collateral ligament and the hamstring tendons through the incision. No joint irrigation liquid is used. The subcutaneous fat tissue is spread and cut using scissors to obtain a clear arthroscopy view. Hamstring tendons are visible at the back side of the sartorial fascia. Using a curved pean or a curved Kelly forceps, the gracilis and semitendinosus tendons are dissected free from the sartorial fascia. This figure shows anteromedial side of the right knee in the flexed position. Superficial medial collateral ligament is seen on the left side. Proximal of the knee is on the upper side. Arthroscopy Techniques 2018 7, e1019-e1024DOI: (10.1016/j.eats.2018.06.007) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 4 The gracilis and semitendinosus tendons are hooked and pulled back together outside the skin incision. The tendons are laterally pulled to detach them from the tibial attachment. The gracilis and semitendinosus tendons are carefully separated by cutting the intertendinous bands with the scissors. Each end of the tendon is whipstitched with a No. 2 nonabsorbable suture (Ethicon). The semitendinosus tendon is pulled by the suture, after which point the first accessory tendinous band of the semitendinosus tendon is visible outside the skin and cut using scissors. This figure shows anteromedial side of the right knee in flexed position. Arthroscopy Techniques 2018 7, e1019-e1024DOI: (10.1016/j.eats.2018.06.007) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 5 The dense fascia ensheathing the tendon that adheres to the soft tissue and other accessory bands that may impede tendon stripping are arthroscopically dissected using Metzenbaum scissors. This figure shows anteromedial side of the right knee in the flexed position. Proximal of the knee is on the right upper side. Arthroscopy Techniques 2018 7, e1019-e1024DOI: (10.1016/j.eats.2018.06.007) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 6 After confirmation that both tendons can move smoothly, the tendons are harvested using a closed tendon stripper (Smith & Nephew Endoscopy). When the tendon stripper stops, other dense fascia, fascial bands, and accessory bands should be reassessed and dissected arthroscopically. This figure shows anteromedial side of the right knee in the flexed position. Proximal of the knee is on the right upper side. Arthroscopy Techniques 2018 7, e1019-e1024DOI: (10.1016/j.eats.2018.06.007) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 7 The gracilis tendon is harvested using the closed tendon stripper. This figure shows anteromedial side of the right knee in the flexed position. Arthroscopy Techniques 2018 7, e1019-e1024DOI: (10.1016/j.eats.2018.06.007) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions

Fig 8 The right knee is extended on the table. The wound is closed using conventional skin sutures. The final wound for the hamstring harvest measures approximately 1 to 1.5 cm. Proximal of the knee is on the right side of the picture. Arthroscopy Techniques 2018 7, e1019-e1024DOI: (10.1016/j.eats.2018.06.007) Copyright © 2018 Arthroscopy Association of North America Terms and Conditions