METHOD OF ONE-STAGE REVISION RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT OF KNEE JOINT Russian patent published in 2023 - IPC A61B17/56 

FIELD: medicine; traumatology; orthopedics.

SUBSTANCE: invention can be used to treat patients with anterior cruciate ligament (ACL) graft failure with extensive expansion of the primarily formed tibial bone canal and relapse of anterior instability of the knee joint using arthroscopic techniques. An allograft of the patellar ligament with the patella is inserted into the femoral and tibial bone canals using arthroscopic technique. The revision tibial canal is formed by processing the primary tibial bone canal. From the center of the primary femoral canal on the inner surface of the lateral condyle of the femur, 7–8 mm are retreated in the anterior direction and a revision femoral bone canal is formed, through the said canal two transverse through tunnels are formed. After determining the diameter and the length of the canals, the allograft is prepared, with its bone part being formed corresponding in size to the revision tibial canal, and the tendon part corresponding in size to the femoral canal. The point of attachment of the tendon part on the bone block is shifted from its center by a distance corresponding to the difference in diameters of the revision tibial and femoral canals. Using the threads with which the end of the tendon part of the allograft is sutured, it is passed first into the revision tibial canal, and then into the revision femoral canal, while the bone block is rotated in such a way that the unstitched portion of the tendon part of the allograft is located along the course of the native anterior cruciate ligament, after which the bone block is hammered until it is wedged in the revision canal of the tibia. To secure the tendon part of the allograft in the femoral canal, a transverse fixation system is installed in the transverse through tunnels.

EFFECT: method provides reliable stabilization of the knee joint due to the immediate plastic filling of the expanded primary bone canal of the tibia and achieving the anatomical position of the tendon part of the graft.

1 cl, 16 dwg, 1 ex