Achilles Allograft

IndicationsAchilles Tendon Allograft

 

Revision

Multi-ligament injury

Older patient

 

Technique

 

Graft preparation

 

Calcaneal bone plug for femoral tunnel

 

Prepare bone plug

- decide on bone graft size needed

- 12 mm wide if revision / 10 mm if primary

- 20 mm long

- 10 mm deep

 

Cut with microsagittal saw

- take central third

- trim to size

- ensure passes nicely through cylinder

- no sharp edges

- drill holes as per normal bone block, 2 x 1 ethibond sutures

 

Achilles Allograft Saw Bone Block 1Achilles Allograft Saw Bone Block 2Achilles Bone Block Saw 3

 

Tendon

- 12 mm wide in man

- 10 mm in woman

 

Keep tendon long

- no need to cut short

- can cut at end of case

- the tendon will remain outside of knee

- fixate this end with Kochers

- no sutures required

 

Achilles Tendon Allograft Final

 

Tunnels

 

Drill tunnels as per standard technique

- beath pin in femur

- drill desired depth to 5 mm more than bone graft length

- eg 25 for 20

- line to line diameter

 

Fixation

 

Pass graft

 

Femoral fixation

- fix with 9 x 25 mm screw if 12 mm tunnel / graft

- otherwise 7 x 25 mm tunnel if 10 mm tunnel / graft

 

Tension graft

 

Tibial fixation

- 9 x 35 mm screw

- augment with staple