ACL internal bracing with pullup and powertape

Abstract

Hamstring autograft became the most popular ACL graft, unfortunately the size (diameter) of graft vary between 7 and 9 mm in many of cases. Literature reveals, that smaller hamstring autograft size is a predictor of poorer KOOS sport/recreation function and leads to revision surgery. Our technical note describes method of preparing larger than 10 mm size hamstring autografts in all cases, which is able to cover as much area of anatomical ACL attachment footprint as possible. Covering ACL footprint we believe improves outcomes after surgery. We describe an anatomic anterior cruciate ligament reconstruction using 8-strand semitendinosus and gracillis grafts fixed with two Pullup adjustable suspensory fixation systems (SBM, Lourdes, France). With this technique outside-in full tibial tunnel, drilling allows easy and quick ACL reconstruction technique with large graft and stable fixation.