AANA19 Knee Access Pass-Master Series_ ACL Reconstruction - What Works in My Hands-Dr. John C. Richmond, M.D.

Master Series_ ACL Reconstruction - What Works in My Hands-Dr. John C. Richmond, M.D.

Video Transcription

Video Summary

The speaker discusses their approach to successful adult ACL reconstruction, emphasizing graft choice and surgical technique. Bone-tendon-bone (BTB) grafts are preferred for high-demand athletes due to better stability and lower revision rates compared to hamstring grafts, though hamstrings may be used in mature, moderate-demand patients. Quadruple semitendinosus grafts increase graft size when needed. All surgeries use medial portal drilling for anatomic positioning, minimizing notchplasty and preserving tibial remnants. Femoral sockets are drilled independently at 120 degrees knee flexion, followed by precise tibial drilling. Fixation uses titanium interference screws for BTB and suspensory flip buttons for soft tissue grafts, with careful cycling and tensioning in full extension for optimal outcomes.

Keywords

ACL reconstruction

Bone-tendon-bone graft

Hamstring graft

Medial portal drilling

Titanium interference screws