ACL Reconstruction Surgery | Behind the Scenes with Dr. Redfern
In this video, Dr. John Redfern from the Colorado Springs Orthopaedic Group provides a behind-the-scenes, arthroscopic walkthrough of a combined ACL reconstruction surgery and a medial meniscus repair on a patient with a chronic injury.
The procedure is broken down into three main phases:
- Joint Clearing and Meniscus Repair
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Initial Preparation: Dr. Redfern uses a shaver to clear out soft tissue and fat pads inside the knee to improve visibility. Because this is a chronic injury, the patient's original ACL remnant has completely reabsorbed, leaving an "empty wall".
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Meniscus Suture Fixation: The doctor shifts focus to a medial meniscus tear. He rasps the tissue edges to create a fresh surface for healing, then uses an "all-inside" device guided purely by the arthroscope. This allows him to place sutures without making extra external incisions.
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He repeats this process to place a total of four vertical sutures, securely tightening the meniscus back down to the bone root.
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- Creating the Bone Tunnels
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Tibial Tunnel: To anchor the new ACL graft, Dr. Redfern outlines the anatomical "tibial footprint". Using a guide pin, he ensures precise alignment before drilling out a 9mm tunnel with a reamer.
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Femoral Tunnel: He locates the posterolateral femoral insertion site at the back of the knee. Using an accessory anteromedial portal with the knee flexed, he drills a guide pin entirely through the lateral thigh skin, followed by a low-profile 9mm reamer to carefully bore the femoral tunnel.
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- Graft Placement and Fixation
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Passing the Graft: The surgical team pulls the ACL graft up through the newly drilled bone tunnels using structural passing sutures.
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Final Fixation: Once perfectly positioned, the doctor anchors the graft on the femoral side using a 7x20mm titanium interference screw. He then secures the opposite end of the graft on the tibial side with a secondary screw, trims the remaining loose sutures, and finishes the operation.
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