Fowler – ACL

Fowler-ACL
-2 bolsters,horizontal portals
-makes medial parapatellar portal and then decides about medial working portal vs. lateral
-elevates table and drops foot portion
-sup. medial drainage
-2 medial portals
-graft harvest; ST + G incise sup. Edge of sartorius above gracilis; uses blunt hooks
-shaves away some of tissue at tibial footprint region but doesn’t worry about shaving OTT until tibial tunnel is drilled
-uses 0.5 mm smaller than graft for tibial tunnel and same size for femoral tunnel
-20mm CL endobutton always
-total tunnel length minus 20 is graft in tunnel (add 10 for flip)
-Accufex at 40 degrees and angles off at 35 degrees (towards MCL)
-Femoral tunnel same size as graft and tibial tunnel 0.5 mm smaller)
-drill K-wire into femur with 3 mm offset OTT guide/use 4.5mm drill and pay attention to distance where it breeches cortex/subtract 12mm and this is the distance to drill the socket(ie. leaving 8 mm for flip)
-mark at subtracted distance and subtract another 10 (2 marks)
-cycle knee and tension at 25 lbs. with 5 staples
-shaves OTT Position