Prelievo dei tendini autologhi per la ricostruzione dei legamenti crociati: Tecnica chirurgica

In the last years there has been a notable improvement in cruciate ligaments reconstructions, due to an evolution of the surgical technique arthroscopic assisted, to a gain of fixation system, to a better choice of the tendons and to an improvement of the operative technique to harvest them. In our experience alternatives are three and the choice depends on the patient peculiarities and on the surgeon habit: 1) Bone - Patellar Tendon - Bone (BPTB); 2) Doubled Gracilis and Semitendinosus Tendons (DGST); 3) Quadriceps Tendon (QT). Our preference, considering the different indications, is for the first two; nevertheless we use the central third of the quadriceps tendon only in particular cases (other techniques failures, revisions, necessity to use more harvests for associated multiple injuries). We describe the harvesting of the grafts that we perform in different surgical phases depending on the tendon choice: the BPTB harvest is done after a diagnostic arthroscopy to confirm the instability and after the tunnel drillings, otherwise the hamstring harvest is done immediately after the diagnostic phase to have more time to tension it, on the mastergraft (workstation).