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Technical TLS: ligamentoplasty anterior cruciate ligament (ACL) in the hamstring TLS or technical DT4 TL

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The aim of this operation is to achieve anatomic ACL reconstruction using autologous (patient's tendon) under arthroscopic control. The principle of TLS is to use a single hamstring tendon in short graft (transplant economy). The half tendon tendon is one of two hamstring tendons (hamstring). It is thin (3-4 mm) and long (about 25 cm). It is the termination of the semitendinosus that ends on the bridle. The harvesting the graft is carried out by a short nearly horizontal incision of 2 cm to the surface of the tibia, is removed only the semitendinosus tendon over its entire length with a stripper. He bent over backwards to get a transplant ACL bundles 4 or 4 strands with diameters ranging from 7 to 9 mm. It's a short graft50 mm average length (Fig.8). At both ends of the graft are passed two textile strips for fixing the graft in tunnels. a traction table is used to make a claim to the graft to 500 Newtons
The procedure is performed arthroscopically: two small incisions of 5 mm either side of the ball joint enable switch the camera and instruments to perform the ligament. The preparation of the notch allows the cleaning of the axial face of the lateral condyle and visualize the area well "over the top" in order to delimit the dial 9-12 and 12-15h for a right knee to the left knee. The femoral tunnel is drilled under arthroscopic control inwards with a specific femoral viewfinder. The knee is at 90 ┬░ of flexion. Tunneling on the spindle diameter 4.5 mm is formed using the 4.5 mm drill. The femoral stall is then excavated using an auger to specific fins. The arthroscope is controlling the retrograde manual digging. The tibial tunnel is achieved according to the same principle. Tractors son went inwards in the femoral and tibial tunnels. The graft is then towed on his bandages and is positioned automatically in the femoral and tibial stall. The graft is fixed with two metal screws Titanium.
 
 
 

Doctor Nicolas LEFEVRE, Doctor Antoine GEROMETTA, Doctor Yoann BOHU, Doctor Serge HERMAN. - 25 octobre 2015.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

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Knee arthroscopy: treatment of meniscus injury

By Dr. Nicolas LEFEVRE , Dr. Serge HERMAN , Dr. Yoann BOHU

Meniscus - Arthroscopic knee surgery is the gold standard of meniscal lesions of the knee. The goal is to treat meniscal tear (tear, crack, tongue, bucket handle ...) being the least traumatic possible for the knee and the most conservative to the meniscus.

 

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