Pitfalls in Single-Bundle Anterior Cruciate Ligament Reconstruction with the Flexible Reamer System by Seung-Yup Lee, Jae-Gyoon Kim, Ki-Mo Jang, and Hong-Chul.

Pitfalls in Single-Bundle Anterior Cruciate Ligament Reconstruction with the Flexible Reamer System

by Seung-Yup Lee, Jae-Gyoon Kim, Ki-Mo Jang, and Hong-Chul Lim

JBJS Case ConnectVolume 4(4):e95October 22, 2014

©2014 by The Journal of Bone and Joint Surgery, Inc.

If the tibial footprint of the ACL is completely debrided, the curved femoral drill guide can rest comfortably on the tibial plateau with a 45° superolateral trajectory.

Seung-Yup Lee et al. JBJS Case Connect 2014;4:e95


Bulky tibial remnants of the ACL (arrow) may interfere with the curved femoral drill guide and not allow it to rest at a superolateral trajectory of 45° (dashed arrow).



In the patients described in Case 1 and Case 2, 6-mm (top) and 7-mm (bottom) flexible reamers, respectively, were broken.



Breakage of the flexible guide pin in Case 2.



The broken 7-mm flexible reamer was removed through the anteromedial portal with use of wire-holding forceps.



Postoperative CT reveals posterior wall blowout (arrow) in Case 1.



An epiphyseal scar (arrowheads) could cause increased resistance (arrow) during femoral reaming.



As noted, posterior cortex blowout occurred in Case 1.



A change in knee flexion after flexible pin placement (arrowheads) would cause acute bending of the flexible guide pin (arrows).



During flexible pin placement (arrowheads), a change in the position of the curved drill guide (closed black arrow) might cause acute bending of the flexible pin (open arrows).



Pitfalls in Single-Bundle Anterior Cruciate Ligament Reconstruction with the Flexible Reamer System by Seung-Yup Lee, Jae-Gyoon Kim, Ki-Mo Jang, and Hong-Chul.

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