case_images: PMC8060088_01
case_images: Lachman test.
case_images: CRIOR2021-5519822.001.jpg
case_images: PMC8060088_01_CRIOR2021-5519822.001.jpg
case_images: fig1
case_images: On physical examination, the knee was unstable with a highly positive Lachman test (Figure 1) and anterior drawer test (Figure 2), there was a mild effusion, collateral ligaments appeared stable, and meniscus signs were negative.
case_images: Anterior drawer test.
case_images: CRIOR2021-5519822.002.jpg
case_images: PMC8060088_01_CRIOR2021-5519822.002.jpg
case_images: fig2
case_images: On physical examination, the knee was unstable with a highly positive Lachman test (Figure 1) and anterior drawer test (Figure 2), there was a mild effusion, collateral ligaments appeared stable, and meniscus signs were negative.
case_images: Preoperative position, draping, and preparing.
case_images: CRIOR2021-5519822.003.jpg
case_images: PMC8060088_01_CRIOR2021-5519822.003.jpg
case_images: fig3
case_images: Under general anesthesia and nerve block, the patient was positioned in supine position on the normal table (Figure 3).
case_images: Quadricep tendon autograft was harvested in the minimally invasive technique.
case_images: CRIOR2021-5519822.004.jpg
case_images: PMC8060088_01_CRIOR2021-5519822.004.jpg
case_images: fig4
case_images: First, a 5 cm x 10 mm x 5 mm quadricep tendon autograft was harvested through a minimally invasive technique (Figure 4) and prepared for an all-inside ACL reconstruction.
case_images: Arthroscopic photo for preparing for tunnels (a) femur drilled tunnel and (b) tibial drilled tunnel.
case_images: CRIOR2021-5519822.005.jpg
case_images: PMC8060088_01_CRIOR2021-5519822.005.jpg
case_images: fig5
case_images: The remnants were debrided, and the femoral and tibial footprints were identified (Figure 5), leaving some tibial fibers in place.
case_images: Fluoroscopic image to confirm epiphyseal drilling.
case_images: CRIOR2021-5519822.006.jpg
case_images: PMC8060088_01_CRIOR2021-5519822.006.jpg
case_images: fig6
case_images: Under fluoroscopy (Figure 6) in true lateral position as well as under direct arthroscopic vision, a guidewire was placed into the exact femoral footprint of the ACL from outside-in.
case_images: Fixation of the quadricep autograft soft-tissue buttons on both the femur and tibia.
case_images: CRIOR2021-5519822.007.jpg
case_images: PMC8060088_01_CRIOR2021-5519822.007.jpg
case_images: fig7
case_images: ABS button (TightRope ABS (Attachable Button System)) (Arthrex) was inserted under direct vision to ensure its direct sit on the bone (Figure 7). A final arthroscopic check of the graft and washout of all debris was performed, wounds were closed, and a brace was put on the leg.