Ultrasonic Technique for Femoral Tunnel Creation in Anterior Cruciate Ligament Reconstruction

Tatsuo Mae; Akira Tsujii; Seira Sato; Takehito Hirose; Yasuyuki Ishibashi; Tomoyuki Suzuki; Ken Nakata

doi:10.1016/j.eats.2023.03.018

Ultrasonic Technique for Femoral Tunnel Creation in Anterior Cruciate Ligament Reconstruction

Arthrosc Tech. 2023 Jul 3;12(8):e1271-e1280. doi: 10.1016/j.eats.2023.03.018. eCollection 2023 Aug.

Authors

Tatsuo Mae¹, Akira Tsujii¹, Seira Sato², Takehito Hirose², Yasuyuki Ishibashi³, Tomoyuki Suzuki⁴, Ken Nakata⁵

Affiliations

¹ Department of Sports Medical Biomechanics, Osaka University Graduate School of Medicine, Japan, Osaka, Japan.
² Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan, Osaka, Japan.
³ Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
⁴ Department of Orthopaedic Surgery, Sapporo Maruyama Seikeigeka Hospital, Sapporo, Hokkaido, Japan.
⁵ Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, Osaka, Japan.

Abstract

Bone tunnel creation in the anatomical location is essential in anterior cruciate ligament (ACL) reconstruction with an autogenous graft and is commonly performed with a drill bit matched to graft diameter. Anatomic rectangular tunnel ACL reconstruction with a bone-patellar tendon-bone autograft has been developed to anatomically create bone tunnels inside the ACL footprints and has been reported to achieve excellent outcomes. To make the rectangular tunnel, the surgeon needs to dilate 2 adjacent bone tunnels after creation of 2 round tunnels with a drill bit, while the tunnel wall occasionally cracks during dilating. An ultrasonic (US) device was developed with improvement of output power and has been implemented with a rectangular shape blade in the field of arthroscopic surgery. This US device can provide a precise and effective bone cut compared to drills. We introduced this device to clinically create a rectangular tunnel during ACL reconstruction. The US device can be useful for rectangular femoral tunnel creation and can create a precise rectangular femoral tunnel in the ACL footprint.