We almost always use the ACL- ThightRope method for this kind of surgeries. Therefore, we remove the Hamstring tendon and the Gracilis tendon via a small incision on the inside of the tibial. Using these two tendons, the plastic of the cruciate ligament is constructed. To aim a better blood circulation and haemorrhage of the tendons we practice not to separate them totally, but leave them stemmed on the tibia. Using arthroscopy, a channel, which calibre depends on the size of the tendon, is drilled through the head of the tibia.
According the modern guidelines of cruciate ligament surgery a matching channel is also drilled into the thigh bone. In the next step the extracted plastic is hooked into the ACL-ThightRope and is pulled through the channel into the joint of the tibial head. The replacement also is pulled through the channel of the thigh bone, where it then is attached and retentioned by using the TightRope.
To attach the cruciate ligament plastic to the thigh-bone, we almost always use the ACL- ThightRope offered by Athrex. Applying this method causes slightly higher material costs, which to us are more than justified by improved patient regeneration and remobilisation.
Using various fixation techniques, from top to bottom (retrograde) or from bottom to top (anteriograde), the ligament is fixated using a bio interference screw. In the end of the surgery a drainage tube, which will be removed before the dismissal, is inserted into the joint.