Operative Techniques
Operative Techniques
The ligaments can be used for extra-articular reconstructions in tendon repair, such as achilles tendon, patella tendon, biceps tendon, etc. These ligaments must always be placed in an anatomical and isometric position. The diameter of the tunnels must correspond to the specific reference for each type of ligament which, as a general rule, should be as small as possible.
The fixation of the ligament extremities must always be extra-articular.
Biological and mechanical testing on resistance, fatigue and creep have shown the ligaments are highly effective ligament reconstruction and augmentation devices. The use of the artificial ligament requires a specific surgical technique, for which dedicated instruments are available.
Implantation Method. A number of guidelines must be respected:
- Isometry is critical to the outcome
- Acute angles must be avoided in the drilling of the bony tunnels
- There must be no impingement or abrasion of the ligament in the joint
- Solid extra-articular fixation must be achieved using interference screws
- Absence of tension in the synthetic ligament is important; the post-operative tension should not be more than that of the anatomical ligament being repaired
- Coverage by fibrous tissue is desirable
- Small incisions should be used to retain proprioception.
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