PMC8060088_01
Lachman test.
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On physical examination, the knee was unstable with a highly positive Lachman test (Figure 1) and anterior drawer test (Figure 2), there was a mild effusion, collateral ligaments appeared stable, and meniscus signs were negative.
Anterior drawer test.
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fig2
On physical examination, the knee was unstable with a highly positive Lachman test (Figure 1) and anterior drawer test (Figure 2), there was a mild effusion, collateral ligaments appeared stable, and meniscus signs were negative.
Preoperative position, draping, and preparing.
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Under general anesthesia and nerve block, the patient was positioned in supine position on the normal table (Figure 3).
Quadricep tendon autograft was harvested in the minimally invasive technique.
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First, a 5 cm x 10 mm x 5 mm quadricep tendon autograft was harvested through a minimally invasive technique (Figure 4) and prepared for an all-inside ACL reconstruction.
Arthroscopic photo for preparing for tunnels (a) femur drilled tunnel and (b) tibial drilled tunnel.
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The remnants were debrided, and the femoral and tibial footprints were identified (Figure 5), leaving some tibial fibers in place.
Fluoroscopic image to confirm epiphyseal drilling.
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Under fluoroscopy (Figure 6) in true lateral position as well as under direct arthroscopic vision, a guidewire was placed into the exact femoral footprint of the ACL from outside-in.
Fixation of the quadricep autograft soft-tissue buttons on both the femur and tibia.
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ABS button (TightRope ABS (Attachable Button System)) (Arthrex) was inserted under direct vision to ensure its direct sit on the bone (Figure 7). A final arthroscopic check of the graft and washout of all debris was performed, wounds were closed, and a brace was put on the leg.