Arthroscopic Anterior Cruciate Ligament Reconstruction Using a Quadriceps Tendon-Patellar Bone Autograft in Press-Fit Fixation

Techniques for anterior cruciate ligament reconstruction that fix the transplant without using hardware offer a variety of advantages over conventional methods. The overall costs of the operation are reduced by eliminating implants, subsequent diagnosis using magnetic resonance imaging is not compromised by metal artifacts, and the conditions for any surgical revision are facilitated. Experimental and clinical investigations have demonstrated that most press-fit techniques are safe and reliable. To date, autologous patellar tendon with bone blocks has mainly been used for this purpose. The disadvantage of this transplant is that discomfort frequently occurs at the donor site. A technique for arthroscopic reconstruction of the anterior cruciate ligament with autologous quadriceps tendon-patellar bone block without using artificial materials to fix the transplant in place is described here. The use of oscillating hollow reamers to obtain a cylindrical patellar bone block and to position the drill channels permit secure femoral press-fit fixation. Tibial fixation of the transplant is achieved by means of a suture-bone bridge and additional bone block fixation of the tendon in the tunnel.