Technique
Incision
- lateral border femur
- 15 cm proximal to knee joint
- curve anteriorly across patella tendon
Harvest ITB
- expose ITB
- width and length depend on patient size
- usually central 3 cm
- take 25 - 30 cm in length
- tubularise end and leave threads long to pass tendon
Lateral dissection
- expose and elevate LCL
- 2cm subperiosteal tunnel above and posterior to this
- pass tendon deep to LCL and through subperiosteal tunnel
- pass inferiorly through intermuscular septum
Posterolateral incision
- anterior to lateral head of gastrocnemius
- allows tendon to be passed around femoral condyle
Medial parapatella incision
- open joint
- make drill hole from anteromedial tibia to posterior to tibial spine
- this prevents anterior impingement
- make appropriate width for tendon
- do so under direct vision
Pass graft
- pass curved instrument through knee and out lateral incision
- retrieve graft into knee
- retrieve through tibial tunnel
- tension
- suture graft at LCL
- pass graft under patella tendon and suture to origin