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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Positioning and Setup of ACL Reconstruction


- Positioning:
    - options include positioning with the patient supine - flat on the table or positioning the patient supine with the knee in a leg holder;
          - supine position:
                 - requires a valgus post, a bump placed under hip, and a bump placed on at the foot of the table to assist w/ knee flexion;
                 - the surgeon can either sit or stand during the procedure;
                       
          - leg holder:
                 - the table is broken to allow full knee flexion (the opposite leg is held with a GYN leg holder);
                 - facilitates the procedure by allowing the surgeon to stand directly in front of the flexed knee (the foot of the table does not get in 
                       the way);
                 - it is helpful to have a padded Mayo table which allows the leg to be propped up and extended intermittently during the case;

- Arthroscopic Pump:
    - typically set between 30 and 50 mm pressure;
    - if a pump is used inflation of a tourniquet is usually not required;

- Tourniquet:
    - a tourniquet is placed on proximal thight, but is not used, unless bleeding becomes a problem later in the case





Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, May 4, 2012 11:39 am