Modified technique for preparation and placement of quadrupled semitendinosus autograft in anterior cruciate ligament reconstruction

Purpose To improve technique of cortical fixation of quadrupled semitendinosus autograft in anterior cruciate ligament (ACL) reconstruction providing a tight contact of the tendon and bone inside the tunnels. Material and methods Application of the technique offered earlier for preparation and placement of quadrupled semitendinosus autograft in ACL reconstruction for a maximal tendon-bone contact is reviewed. The technique uses cortical buttons for semitendinosus graft fixation. Proximal and distal ends of the graft are corrugated at placement, thus increasing the diameter and providing additional fixation inside the bone tunnels. The modified technique employs same corrugated sutures with an easier placement practice. Potential fixation tightness in the tunnels is assessed by an increase in the diameter at both ends of the prepared graft while tightening corrugated sutures. Six semitendinosus tendons of 3 cadavers were used for testing. Results Diameters of the proximal and distal ends of the graft prepared with modified technique increased by 1...