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Fertilized ACL with Complex Double Sutureloc Meniscal Root Repair
Dr. Garcia specializes in complex knee, shoulder and elbow sports surgeries. He has prepared a number of surgical videos below to help patients better understand their procedures. He is frequently updating his surgical video database so check back soon for further updates.
This video features Dr. Grant H. Garcia demonstrating a complex knee surgery involving a "fertilized" Anterior Cruciate Ligament (ACL) reconstruction performed alongside simultaneous repairs of both the medial and lateral meniscus roots, utilizing the Arthrex SutureLock system.
Here is a breakdown of the surgical procedure demonstrated in the video:
- Assessment and Preparation: The surgery addresses a unique medial meniscus tear (a trimmed discoid type) with an associated root tear, as well as a lateral root tear that was discovered during the procedure despite not appearing on the initial MRI. Dr. Garcia begins by carefully preparing the bone beds where the roots will be reattached.
- Strategic Anchor Placement: Guide pins for the SutureLock anchors are placed far medially and laterally to ensure they do not interfere with the main tunnel being created for the ACL graft. These pins are intentionally left in place while reaming the ACL tunnel; this acts as a safeguard to deflect the reamer and prevent it from damaging the meniscal anchor constructs.
- Fertilized ACL Graft: A quadriceps tendon graft, enhanced with a bone marrow aspirate (referred to as a "fertilized" ACL to promote healing), is introduced into the joint and secured in place.
- Final Tensioning: Crucially, the final tensioning of the meniscal root repairs is performed only after the ACL graft has been fully secured. The surgeon alternates tensioning both the medial and lateral sides, pulling the meniscus firmly back to its root attachment, which restores joint tightness and improves meniscal extrusion.
