Anterior Cruciate Ligament Reconstruction Using an Endoscopic Technique With Patellar Tendon Autograft

The single-incision endoscopic-guided ACL reconstruction using patellar tendon autograft is advocated for its high ultimate strength, bone to bone healing, and interference fixation. Optimal outcomes are obtained when attention is paid to crucial technical aspects of the procedure. In addition, attempts should be made to reestablish full range of motion in the affected knee prior to surgery. The technically-demanding graft harvest portion of the procedure focuses on obtaining a graft with appropriatelysized bone plugs and adequate tendon girth while minimizing trauma to the knee. Notch preparation and tunnel placement allow for the graft to be appropriately oriented without impinging in the notch in extension. Metal interference screws are used for fixation both at the femur and the tibia. An aggressive physical therapy program is initiated postoperatively.