FIELD: medicine.
SUBSTANCE: invention relates to medicine, particularly to traumatology and orthopedics. A front-medial arthroscopic approach is performed under visual control through a lateral arthroscopic approach. Anterior-medial arthroscopic approach is performed in a knee flexure position at angle of 90-100° at distance of 2-2.5 cm medial to the patellar ligament and 1-1.5 cm above the anterior horn of an internal meniscus. A femoral guide with offset is inserted into the joint cavity, the value of which is selected proceeding from the diameter of the prepared transplant of the anterior cruciate ligament, and is placed on posterior-lateral edge of the posterior intercondylar notch, oriented to the center of attachment of the native anterior cruciate ligament to the femoral bone. Guide is used to guide pin and to form hole in femoral condyle of femur. Guide wire and spoke are removed. A jointed cannulated drill is drilled into the joint cavity under arthroscopic control; the drill head corresponds to the diameter of the prepared transplant; it is brought along the anterior part of the joint, parallel to the internal condyle of the femur and above the anterior horn of the inner meniscus. Guiding pin is guided through the drill and the assembled system of the head cannulated drill is rotated with the guide pin on the inner surface of the femoral condyle to the previously prepared opening in the center of the anterior cruciate ligament attachment. A guide pin is arranged in this opening to define further direction of the drill and femoral canal. After the drill is arranged opposite the external condyle of the femoral bone, the shank of the drill bit is fixed in the drill, and a femoral canal is reamed through the installed guide pin.
EFFECT: method enables reducing the risk of iatrogenic damage of the articular cartilage of the medial condyle of the femoral bone and the anterior horn of the medial meniscus, creating a femoral canal of sufficient length more than 20-25 mm, without risk of destruction of its posterior wall, placing the femoral canal almost parallel to the shinbone plateau, improving biomechanics of an anterior cruciate ligament transplant and reducing the risk of its impingement and damage.
1 cl, 1 ex
