Arthroscopic anterior cruciate ligament reconstruction using quadriceps tendon autograft and bioabsorbable cross-pin fixation.

We describe a technique for arthroscopic anterior cruciate ligament (ACL) reconstruction using the middle third of the quadriceps tendon without a patellar bone block and absorbable tibial and femoral cross-pin fixation. The central part of the quadriceps tendon is harvested through a 5-cm long anterior skin incision without a patellar bone block. Tibial and femoral tunnels are prepared, the graft is passed up the tunnels, and is fixed both in the femur and the tibia using absorbable cross pins (Rigid Fix; Mitek, Johnson & Johnson, Norwood, MA). In this way, the graft is stabilized near the joint line, providing outlet fixation. In our practice, very good results have been obtained with the use of this technique.

Intraoperative arthroscopic suture anchor reloading.

The success of an arthroscopic procedure depends considerably on the successful and secure tying of arthroscopic knots, which reapproximate and stabilize avulsed or torn soft tissues to their original bed. Failure to perform appropriate knot tying may jeopardize the success of the operation. We describe a simple and reliable technique for intraoperative arthroscopic replacement of the suture through the eyelet of an already-inserted bone anchor. This technique allows for replacement of a fretted suture or a loose knot with a new suture, offering the opportunity to repeat the knot tying procedure with a new intact suture.

The triad knot: a new sliding self-locking knot.

Tying secure knots is essential in arthroscopic surgery. A new slip knot for arthroscopic shoulder surgery is described. Locking of the knot is accomplished by pulling the post strand. Knot tying is simple and a low-profile, secure knot is produced.