APEX Optimizing Surgical Outcomes for Knee & Shoulder Arthroscopy-Seleccion de injertos y fijacion en la reconstruccion de Ligamento Cruzado Anterior

Seleccion de injertos y fijacion en la reconstruccion de Ligamento Cruzado Anterior

Video Transcription

Video Summary

Michel Ruiz from Mexico City discusses graft selection and fixation in anterior cruciate ligament (ACL) reconstruction, emphasizing that no single graft or fixation method suits all patients. Key considerations include patient-specific factors, surgeon experience, and understanding each graft's advantages and disadvantages. The autologous patellar tendon bone graft remains the gold standard due to better biological integration and rigid fixation but carries risks like patellar fracture and anterior knee pain. Quadruple autologous hamstrings offer easier harvest with smaller scars but have unpredictable diameter and slower biological incorporation. The quadriceps autograft is gaining popularity for its biomechanical performance and consistent diameter but varies in harvesting techniques. Peroneus longus grafts are emerging but lack extensive outcome data. Allografts reduce donor site morbidity and surgery time but face issues around cost, slower incorporation, and sterilization effects. Synthetic ligaments are costly with unproven benefits. Fixation devices must provide strength, rigidity, and security; interference screws remain common. Proper technique and individualized graft-fixation choices optimize surgical success and patient outcomes, prioritizing function and quality of life.

Asset Caption

Faculty: Michell Ruiz-Suarez, M.D.

Keywords

anterior cruciate ligament reconstruction

graft selection

graft fixation

autologous patellar tendon graft

hamstring autograft

allograft