Endoscopic single-incision anterior cruciate ligament reconstruction using patellar tendon autograft: surgical technique. 1992 [classical article].

Anterior cruciate ligament (ACL) reconstruction has undergone numerous advances over the past two decades. In the early 1970s, Jones21 popularized open arthrotomy reconstruction using the central one third of the patellar ligament. The 1980s witnessed arthroscopic-assisted techniques that obviated the use of an arthrotomy.3,19,37 Endoscopic ACL reconstruction using a single anterior incision is an attractive technique modification that is currently being investigated as a potential advance over arthroscopic-assisted techniques.31,33,35 Single-incision endoscopic ACL reconstruction has the advantages of arthroscopic-assisted ACL reconstruction and offers several advantages over mini-arthrotomy techniques.* These include improved visualization for graft placement and isometry, exposure provided by fluid distention thus avoiding cartilage desiccation, possibly less thigh girth atrophy, avoidance of an arthrotomy-induced loss of proprioception, improved cosmesis, decreased postoperative pain, and simpler wound care. Reduced postoperative morbidity will allow the future single-incision technique to be performed routinely on an outpatient basis. This may help reduce costs and improve health-care use. Despite the many advantages associated with endoscopic ACL reconstruction, it is a technically demanding procedure with many potential pitfalls.27 This article describes the surgical technique and pitfalls of single-incision endoscopic ACL reconstruction using patellar tendon autograft. SURGICAL TECHNIQUE