Avoiding Flexible Reamer Breakage During Anatomic ACL Reconstruction.

Abstract

As outlined in our January 16, 2013 editorial, “The Case Report Redefined with JBJS Case Connector ,” one important role of JBJS Case Connector is to alert the orthopaedic community about a potentially problematic device or therapy. When two or more such cases with similar mechanisms appear, we will identify the procedure or implant as a “watchable” intervention. While this system is not statistically conclusive and may or may not be supported by other published case reports or registry data, the intention is to sharpen the focus of clinicians on the potential for similar problems and thereby enhance clinical outcomes and patient safety. The “Watch” designation may also encourage others to report related difficulties and enlist the orthopaedic community to either demonstrate that these are isolated, unrelated cases or sharpen the focus further on rigorously evaluating the intervention. Where appropriate, we may identify brand, model, or implant-lot specifics. Anatomic reconstruction of ruptured anterior cruciate ligaments (ACLs) offers well-documented advantages over nonanatomic approaches. Optimal tunnel parameters contribute much to the success of anatomic ACL reconstruction. For single-bundle anatomic techniques, some surgeons have begun to curve tunnels slightly rather than drill straight ones. Users of the curved approach say it allows them to achieve longer tunnel lengths, reduce the risk of iatrogenic injury, and avoid the need for knee hyperflexion and notchplasty. The desire among some surgeons to create curved tunnels has prompted manufacturers to develop flexible drill guides and reamers. In the October 22, 2014 JBJS Case Connector , Lee et al. report on two cases of …