Anterior Cruciate Ligament Tunnel Placement Using the Pathfinder Guide

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Presentation transcript:

Anterior Cruciate Ligament Tunnel Placement Using the Pathfinder Guide Karan A. Patel, M.D., Anikar Chhabra, M.D., Justin L. Makovicka, M.D., Joshua Bingham, M.D., Dana P. Piasecki, M.D., David E. Hartigan, M.D. Arthroscopy Techniques Volume 6, Issue 4, Pages e1291-e1296 (August 2017) DOI: 10.1016/j.eats.2017.05.009 Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 1 Adequately debrided tibial tunnel to ensure ease of graft passage. Left knee, viewed from the anterolateral portal. Arthroscopy Techniques 2017 6, e1291-e1296DOI: (10.1016/j.eats.2017.05.009) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 2 Pathfinder guide in the over-the-top position with plastic sheath. Be certain that plastic sheath is bottomed out on guide to ensure proper direction of femoral tunnel. Left knee, viewed from the anterolateral portal. Arthroscopy Techniques 2017 6, e1291-e1296DOI: (10.1016/j.eats.2017.05.009) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 3 Femoral tunnel position in the standard transtibial technique (A) compared to the Pathfinder guide (B). Note the more vertical orientation via the transtibial technique. Left knee, viewed from the anterolateral portal. Arthroscopy Techniques 2017 6, e1291-e1296DOI: (10.1016/j.eats.2017.05.009) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 4 Femoral tunnel should be reamed using a flexible reamer over the guide wire. Left knee, viewed from the anterolateral portal. Arthroscopy Techniques 2017 6, e1291-e1296DOI: (10.1016/j.eats.2017.05.009) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 5 A more oval aperture is created allowing greater graft/native anterior cruciate ligament footprint overlap. Left knee, viewed from the anteromedial portal. Arthroscopy Techniques 2017 6, e1291-e1296DOI: (10.1016/j.eats.2017.05.009) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions