Surgery-Contralateral

Surgical technique

The surgical technique for contralateral PTG ACL reconstruction is the same as ipsilateral PTG ACL reconstruction except that the opposite leg is prepared and draped at the begining of surgery and the graft is taken from the other leg.

* The steps are exactly the same as the ipsilateral surgery up to stage 10 , with the addition that the pre-emptive local anaesthetic is also injected into the subcutaneous tissues of the donor leg pre-operatively in the anaesthetic room.
* Once the tunnels have been dilled in the ACL leg, the tourniquet is inflated on the donor side and a similar incision is made on the donor side as on the ACL reconstructed leg. Through this incision, the central third of the patella tendon and bone blocks are harvested.
* The wound is then packed and bandaged and the tourniquet released on the donor site.
* At the end of the operation, the bone reamings from the tunnels in the ACL reconstruced leg are then grafted into the bone block harvest sites on the donor leg.
* The patella tendon defect is then closed on the donor side.
* The rest of the donor site wound is then closed. The donor leg is maximally flexed ( bent
* Local anaesthetic is injected into the donor side wound and the wound dressed.
* A TED stocking is then applied to the donor leg.
* Ice is then bandaged to the donor leg and left on for 30 minutes. The ice is then removed and left off for 30 minutes, before it is re-applied. This procedure of ice on for 30 minutes and off for 30 minutes is continued during the daytime for the first week after surgery. The ice must not be left on for more than 30 minutes as this may result in a skin burn.



Ice burn on the medial aspect of the knee from ice being applied directly to the skin for long periods of time.

*   The rest of the operative technique is the same as for ispilateral ACL reconstruction .

Below are pictures of the a patient returning from theatre having had a contralateral PTG ACL reconstruction, with each leg in a CPM machine and ice on the right knee and a Cryo-cuff on the ACL reconstructed left knee.

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