Anatomic Double-Bundle Reinsertion After Acute Proximal Anterior Cruciate Ligament Injury Using Knotless PushLock Anchors Patrick Weninger, M.D., Florian.

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Anatomic Double-Bundle Reinsertion After Acute Proximal Anterior Cruciate Ligament Injury Using Knotless PushLock Anchors Patrick Weninger, M.D., Florian Wepner, M.D., Florian Kissler, M.D., Michael Enenkel, M.D., Christian Wurnig, M.D. Arthroscopy Techniques Volume 4, Issue 1, Pages e1-e6 (February 2015) DOI: 10.1016/j.eats.2014.09.007 Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 1 Acute proximal avulsion–type ACL injury (arrow) with blood clot in footprint (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 2 Microfracture awl in femoral footprint (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 3 Setting 2 to 3 microfractures in femoral anteromedial footprint (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 4 Setting 2 to 3 microfractures in femoral posterolateral footprint (left knee, central-portal view, 120° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 5 A SutureLasso (black arrow) is passed through the posterolateral bundle (white arrow) (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 6 A TigerWire is passed through the posterolateral bundle (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 7 A FiberWire is passed through the anteromedial bundle, and both ends are passed through the medial portal with a KingFisher (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 8 The free end of the TigerWire is passed through the anteromedial portal with a KingFisher (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 9 The FiberWire and TigerWire are both outside the anteromedial portal (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 10 The hole for the PushLock anchor for posterolateral bundle reinsertion is drilled in the posterolateral footprint (arrow) (left knee, central-portal view, 120° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 11 PushLock insertion for posterolateral bundle reinsertion (left knee, central-portal view, 120° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 12 Inserted PushLock (arrow) and reattached posterolateral bundle (left knee, central-portal view, 120° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 13 ACL after reinsertion of anteromedial bundle in 90° of knee flexion to femoral anteromedial footprint with additional PushLock anchor (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 14 The stability of the reinserted ACL is tested (left knee, central-portal view, 90° of knee flexion). Arthroscopy Techniques 2015 4, e1-e6DOI: (10.1016/j.eats.2014.09.007) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions