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Journal of Experimental Orthopaedics
Fig. 8 | Journal of Experimental Orthopaedics

Fig. 8

From: Excellent short-term results of dome-shaped high tibial osteotomy combined with all-inside anterior cruciate ligament reconstruction

Fig. 8

a A 2.4 mm-diameter Kirschner steel wire is driven through the targeted femoral ACL footprint site into the intraarticular space. Then, the femoral tunnel diameter is enlarged by applying a 4.5 mm-diameter. A special drill guide pin (Black arrow) which has an apertured tip with 2–0 nylon loop was inserted to intraarticular portion in order to deliver the reamer bit inside the joint. Black arrow: A special drill guide pin. b The nylon loop is extracted at outside of the medial portal. A guiding nylon thread is passed through the reamer bit opening (*) and is used to deliver the reamer bit into the intraarticular space using a reamer pusher (**) and passes the drill guide pin through the reamer bit opening. *: The reamer bit opening, **: A reamer pusher. c Transfemoral drilling of both tibial and femoral sockets was performed in an all-inside manner using a custom-designed drill guide pin–reamer bit system. The drill pin and reamer are fixed at the inside of the knee joint, and the drill pin was rotated clockwise (curved arrow) and advanced to create the tibial socket (①) and then retracted to create the femoral socket (②) [Takahashi 2023]

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