Graft Retensioning by Dialing of Suture Disk on Tibial-Side Fixation in Arthroscopic Anterior Cruciate Ligament Reconstruction: Pathak Pune Dialing Technique.

Arthroscopic anterior cruciate ligament (ACL) reconstruction is a common procedure performed for symptomatic ACL tears, especially in athletes. The desired surgical end product with any surgical fixation device remains a taut ACL graft, which is crucial during postoperative rehabilitation to reduce the risk of knee instability and rerupture of the ACL graft. The purpose of this Technical Note and accompanying video is to describe a simple and cost-effective technique to easily retension the ACL graft after tibial fixation in ACL reconstruction using a suture disk device. The technique uses a simple suture disk device to provide strong tibial fixation, along with the unique ability to retension the ACL graft by dialing it in a clockwise direction.

Modified Surgical Technique of Making Posteromedial Portal in Knee Arthroscopy Using a Radiofrequency Device.

In knee arthroscopy, a posteromedial portal is used for various indications including arthroscopic posterior cruciate ligament reconstruction, posterior cruciate ligament avulsion fracture fixation, posterior medial meniscal repair, medial ramp lesion repair, and synovectomy. Making the posteromedial portal is challenging for young and even experienced surgeons. Creating the posteromedial portal in knee arthroscopy is challenging and technically demanding for surgeons because of the thick muscular cover, proximity of the neurovascular bundle, tenacious tough capsule, and excessive fat deposition in the posteromedial knee and thigh region. Access for viewing the posteromedial compartment during different procedures is made simple, safe, and replicable with this technique of creating the posteromedial portal. This article describes a simple way to create the posteromedial portal using a radiofrequency device by a modified outside-in surgical technique.