Abstract
Strong initial fixation of the graft is essential for successful early rehabilitation
before full graft incorporation. The modified bone–hamstring–bone (BHB) composite
graft procedure is a hybrid method that lacks the disadvantages of the bone–patellar
tendon–bone and semitendinosus and gracilis tendon methods while retaining the advantages
of these methods. We describe the modified BHB composite graft procedure used by our
surgical team. Two cancellous bone cylinders, 2 cm long and 8 mm in diameter, were
taken out of the tibial tunnel and fixed to both ends of the graft by use of sutures.
One end of the graft was put into a pressing device to achieve a graft diameter of
9 or 10 mm, and then the other end was pressed. By doing so, very strong end parts
of the graft were obtained. The graft was then passed through the tibia into the femoral
socket, and once the graft had been properly positioned in the tunnel, it was fixed
with round cannulated interference screws (RCI; Smith & Nephew Endoscopy, Andover,
MA). This technique of BHB graft preparation allows precise and strong early fixation,
promotes biologic fixation, and does not cause patellofemoral joint disorders.
Key Words
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References
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Article info
Publication history
Published online: January 08, 2007
Footnotes
Cite this article as: Milankov M, Miljkovic N, Savic D. Anterior cruciate ligament reconstruction using compressed bone–hamstring–bone graft. Arthroscopy 2007;23:442.e1-442.e3 [doi:10.1016/j.arthro.2006.07.043].
The authors report no conflict of interest.
Identification
Copyright
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
