Do not harvest >40% of the tendon width. [17-19] However, whether the risk of CACL tear is . Epub 2019 May 16. Anterior Cruciate Ligament (ACL) Repair with Allograft reconstruction surgery is generally safe. Copyright - St. George Surgical Center -, ChondroplastyCartilage Debridement (Arthroscopic). 2. Which ASC chain has the most surgery centers? Femoral interfence screw should be anterior to graft. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. All Rights Reserved. I suffered with pain in both knees for years. Preparation You will usually have ACL reconstruction three to eight weeks after your injury. TECHNIQUE STEPS. Over the past decade, use of allografts has risen as processing of grafts has improved its safety profile. Arthrosc Tech 2012;1:e165-e168. Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs. This site needs JavaScript to work properly. He had is team ready at the hospital and operated on me within 6 hours after my injury. ACL or anterior cruciate ligament reconstruction with a quadriceps tendon autograft is a surgical procedure to replace or reconstruct a torn ACL ligament of your knee with part of the quadriceps tendon taken from your own leg. The allograft is usually irradiated to kill any infectious agent such as bacteria/viruses. endstream
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Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result. Femoral tunnel should be at least 60% posterior along Blumensaat's line. Each surgeon dictates their own surgical procedure in a separate operative note outlining their part of the procedure. An open revision ACL could also be reported with the unlisted code (29999) or by appending modifier -22 to the original ACL code. Before ]}yk
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Ux*j*V]bXD) n_EX*,6=v Careers. Results Of 16 131 included patients, 44% did not achieve the MIC for the combined Sport/Rec and QoL subscales 1 year after ACL-R. From the multivariable stepwise logistic regression, older patients (OR 0.91, 95% CI 0.88 to 0.94; p<0.0001), males (OR 0.93, 95% CI 0.87 to 0.99; p=0.034) and patients receiving hamstring tendon autograft ACL-R (OR 0.70, 95% CI 0.60 to 0.81; p<0.0001) had lower . The graft material may either be harvested from the patients own body which is known as autograft or from a cadaver known as an allograft. He developed a complication of torn ACL graft and underwent further arthroscopic ACL revision with hamstring autograft and anterolateral ligament reconstruction. The information on this website may not be complete or accurate. Allograft Augmentation of Hamstring Anterior Cruciate Ligament Autografts Is Associated With Increased Graft Failure in Children and Adolescents. Hamstring Tendon Autograft. Very friendly office and I'm glad to be a patient here. These ligaments are strong fibrous bands of tissue that attach to the femur, fibula patella and tibia bones providing strength and stability to the joint. Author links open overlay panel Derek N. Pamukoff a, Melissa M. Montgomery a, Skylar C. Holmes a, Tyler J. Moffit a, Steven A. Garcia a, Michael N. Vakula b. .8SX"A5$`
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This was the right decision no pain and no limp. The tendons are quadrupled to increase their strength. Two hamstring tendon grafts were harvested from the right extremity. registered for member area and forum access, http://www2.aaos.org/aaos/archives/bulletin/apr05/code.asp. Usually 25-45mm. FOIA The office staff is the best, love Andrea.You wont find a better doctor. Please enable it to take advantage of the complete set of features! Int J Surg Case Rep. 2020;76:81-84. doi: 10.1016/j.ijscr.2020.09.136. Measure femoral tunnel length. and transmitted securely. He explained everything to us, and the office staff set everything up for us and made the process easy. The patients were examined at 2 years after surgery. To care for your incision while it heals, you need to keep it clean and dry and watch for signs of infection. endstream
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Vertical tunnels cause decreased flexion. This protocol is intended to be a general outline only. ACL injuries most commonly occur during sports that involve sudden stops and changes in direction such as soccer, football, basketball and volleyball. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Open anatomical coracoclavicular ligament reconstruction. The anterior cruciate ligament reconstruction surgery involves the use of an arthroscope to reconstruct the torn anterior cruciate ligament with graft tissue. The patient portal made it easy for me to access all my documents including work notes. You will usually have ACL reconstruction three to eight weeks after your injury. This is uncommon, and sometimes another surgery or manipulation under anesthesia can help. The staff here are great, I was seen at the time of my appointment and was well taken care of! Helpful Codes For Osteochondral Allograft Procedures In The Talus And Ankle, Helpful Codes For Osteochondral Allograft Procedures In The Shoulder, Helpful Codes For Allograft Meniscus Reconstruction, Helpful Codes For Osteochondral Allograft Procedures In The Distal Femur. graft should be 9-10mm wide or 1/3 of tendon width. official website and that any information you provide is encrypted Graft harvestation is the first step in autograft ACL reconstruction. Insert screw. It may not display this or other websites correctly. Loss of stability / Graft failure: @10% (more common in patients younger than 20)(Webster KE, Feller JA, Leigh WB, Richmond AK. Ohio State College of Medicine | Ohio State College of Medicine TECHNIQUE VIDEO. Snaebjrnsson T, Hamrin Senorski E, Ayeni OR, et al. I was taught that if it's a separate incision, you can use 20924. Setting up physical therapy is right there as well.I'm so glad I found this place. Knee. This CPT code is valued to include the harvesting and placement of a graft. 2000;8:226). HHS Vulnerability Disclosure, Help The surgeon drills small holes into the upper and lower leg bones where these bones come close together at the knee joint. People seeking specific medical advice or assistance should contact a board certified physician. Intraoperative photograph (left leg) showing the use of the tendon stripper to harvest the gracilis tendon after whip-stitching the free end with a high-strength nonabsorbable suture (Ethicon). Gracilis=rounder, palpable, proximal. Arthroscopy. Cpt Code For Acl Reconstruction With Allograft PDF Download May 1st, 2018 - Cpt Code For Acl Reconstruction With Allograft Acl reconstruction with allograft vs autograft aapc i would really appreciate your assistance with clarification when an acl reconstruction is performed 29888 is the Chronic Distal Biceps Repair With an Achilles Allograft Combined hamstrings and peroneus longus tendon for undersized graft in anterior cruciate ligament reconstruction: A report of two adolescence female patients. There are several tendons available for grafting. Now After 3 months of great care by him and his staff, I am walking to normalcy. I was up walking mere hours after the surgery, and on the workout machines the next morning. Complications that may arise from surgery or during rehabilitation (rehab) and recovery include: Located in sunny St. George, in southern Utah, SGSC is a multi-specialty surgical facility, physician-owned and operated. BTB vs Hamstring outcomes: Graft failure(1.9% versus 4.9%); KT-1000 arthrometer side-to-side difference less than 3 mm(79% versus 73.8%); Rate of manipulation under anesthesia or lysis of adhesions (6.3% versus 3.3%); Anterior knee pain (17.4% versus 11.5%);Hardware removal (3.1% versus 5.5%). Note: These lists of codes may not be all-inclusive. This graft is also known as a bone-patellar tendon-bone (BPTB) graft. Peroneus Longus Tendon Harvesting for Anterior Cruciate Ligament Reconstruction. Allograft may be from a cadaveric achilles tendon, tibialis anterior/posterior tendon, hamstrings or patellar tendon. June 7, 2020. by | Jun 3, 2022 | four factors leading america out of isolationism included | cheng yi and crystal yuan latest news | Jun 3, 2022 | four factors leading america out of isolationism included | cheng yi and crystal yuan latest news Butt UM, Khan ZA, Amin A, Shah IA, Iqbal J, Khan Z. JBJS Essent Surg Tech. Disclaimer. Intraoperative photograph (left leg) showing the location of the sartorial fascia. Problems related to the surgery itself. Am J Sports Med. The Short Graft Anterior Cruciate Ligament (ACL) reconstruction is increasing in popularity. You may also be asked to give your consent for the procedure by signing a consent form. Other autografts that may be used for ACL reconstruction include the quadriceps tendon and the peroneal tendon. These tendons are then doubled over, resulting in a 4 stranded graft. 2022 Jun 20;12(2):e20.00053. I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . MCL Repair Contraindications Thank You. The appropriate test, x-rays were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Tunnel angled @45 degrees drill/dilate to size. 2022 Jun 30;22(1):254. doi: 10.1186/s12893-022-01685-x. (Jackson DW Arthroscopy 1994;10:124-131). Houston Methodist Orthopedics & Sports Medicine. Dr. Vaksha was very thorough and kind. 2013-05-15 Price: $6,790.00. This study aimed to investigate the association between the IKDC2000 and the KOOS subscales and the return to . Ensure interference screw is not divergent. I fought it for years, as I was just afraid. I would highly recommend him. In studies comparing outcomes of patellar tendon and hamstring autograft ACL reconstruction, the rate of graft failure was lower in the . I would refer this office to anyone who needs a great orthopedic doctor. For revision ACL reconstruction consider freeze-dried allograft bone dowels to fill bony defects. See Site Terms / Full Disclaimer. 3-4cm incision 3 fingers breadths below medial joint line, midline tibial shaft between crests. In rare cases, the kneecap may be fractured while the graft is being taken during surgery or from a fall onto the knee soon after surgery. Perkins CA, Busch MT, Christino M, Herzog MM, Willimon SC. Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. Rehab attempts to restore a range of motion between zero degrees (straight) and 130 degrees (bent). Intraoperative photograph (left leg) showing the use of the tendon stripper to harvest the semitendinosus tendon after whip-stitching the free end with a high-strength nonabsorbable suture (Ethicon); the gracilis tendon has previously been harvested. It was the afternoon of Friday Sept. 24. 3-4mm offset femoral tunnel guide used to place guide wire in the 11oclock position for right knee. Cut grafts to 24cm and prepare on back table with #2 Ethibond whip stitches in each end. Active Comparator: Quadriceps tendon Patients in this arm will undergo soft-tissue autograft reconstruction using all-soft-tissue quadriceps (i.e. A prospective comparison of 3 hamstring ACL fixation devices-rigidfix, bioscrew, and intrafix-randomized into 4 groups with a minimum follow-up of 5years. The work associated with this is included in the payment for CPT 29888. Anterior Cruciate Ligament (ACL) Repair with Allograft reconstruction is one of the most common procedures performed by orthopedic surgeons. Hamstring Autograft versus Patellar Tendon Autograft for ACL Reconstruction: Is There a Difference in Graft Failure Rate? I had an issue with paperwork and she cleared it right up. A meta-analysis of bone-patellar tendon-bone autograft versus four-strand hamstring tendon autograft for anterior cruciate ligament reconstruction. Similarly, hamstring autograft may cause inhibition of the hamstrings. The spine surgeon expects 100 percent reimbursement on 22845 and 22851. Patellar Tendon Autograft This is the "gold-standard" for ACL reconstruction and has been used for over 40 years as a reliable, safe graft for ACL reconstruction. The OATS procedure focuses on chondral defects that are associated with chronic tears of the anterior cruciate ligament (ACL), using an arthroscopic approach that can provide access to both the ACL for reconstruction and performance of the autograft. An official website of the United States government. suri cruise school 2021. Mall N.A., Chalmers P.N., Moric M. Incidence and trends of anterior cruciate ligament reconstruction in the United States. ie tendon width should be >25mm. Problems with the graft tendon (loosening, stretching, reinjury, or scar tissue). From the time I entered Dr. Karkares office for the first time until now, his staff has been amazing. You will feel tired for several days. If you have a general anesthetic it means you will be asleep during your operation. Patellar Tendon Autograft June 7, 2020 The patellar tendon autograft is the second most common choice used for an ACL reconstruction autograft after the hamstring tendon autograft. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best. Jackson DW editor, Master Techniques in Orthopedic Surgery: Reconstructive Knee Surgery 2nd Ed, 2002. check alignment, joint space and patella alignment. Thank you! (Fineberg Arthroscopy 2000;16:715), Tunnel position is the most common cause for technical failure. The grafts of choice are the hamstring and quadriceps tendon autograft. My profile page has all of my educational information, work experience, and all the pages on this site that I've contributed to. 27427 27429 See all ligamentous knee CPT codes. 1. I appreciate the guidance and knowledge you have shared. cpt code for open acl reconstruction with hamstring autograft. The information on this website is intended for orthopaedic surgeons. Outside-in technique versus inside-out semitendinosus graft harvest technique in ACLR: a randomised control trial. ACL Hamstring Tendon Autograft Reconstruction Protocol The intent of this protocol is to provide the clinician with a guideline for the post-operative rehabilitation course of a patient that has undergone an ACL hamstring tendon autograft reconstruction. Epub 2020 Sep 23. Hn1E^jlgKQ"Ruh6,*kc3_guq1,QWf;2vz*Oen6FY5|a=7FQ"cL{=Y9qU/8wwY=~:#wvIemCB!W)7\Fto*vh. The patient is educated regarding the type of graft to be used for their surgery. Clamp the superior border of the incised sartorial fascia and use the scissors to release the superior medial edge in a hockey stick fashion for exposure of the tendons. ACL reconstruction is surgery to replace a torn anterior cruciate (KROO-she-ate) ligament (ACL) a major ligament in your knee. 817-375-520024/7 Scheduling Payment Portal Show more. What a great place! Drill femoral tunnel to 35mm with acorn reamer. All Rights Reserved. Discuss the possible options with your orthopedic sports surgeon before surgery. I would highly recommend this office. 2020 Jan 23;9(1):e191-e198. This creates a two- or four-strand tendon graft. ACL reconstruction can be done using either local or general anesthesia. ), Anterior knee pain / kneeling pain: 17.4%/100% BTB, 11.5% Hamstring. Offset <5mm. Some surgeons use an additional tendon, the gracilis, which is attached below the knee in the same area. Am I wrong? Dr Vaksha was so kind and helpful. PMC I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. 2021 Sep 24;8(1):80. doi: 10.1186/s40634-021-00396-1. Rebecca is such a kind and understanding person. Houston Methodist Orthopedics & Sports Medicine. The vascular surgeon expects 16 percent of the allowable for CPT 22845-80 and 22851-80.Learn more about KarenZupko & Associates at www.karenzupko.com.The information provided should be utilized for educational purposes only. HCPCS code G0289 may be reported in addition to CPT code 29880, Arthroscopy, knee, surgical; with . The patient is a 17-year-old male, who had previously undergone anterior cruciate ligament (ACL) reconstruction. ACL Patella Tendon Autograft Reconstruction Protocol ACL Patella Tendon Autograft Reconstruction Protocol The intent of this protocol is to provide the clinician with a guideline for the post-operative . Postoperative images showing quadriceps tendon autograft scar and range of motion. The autograft at times may not be of the required thickness and length to substitute the natural ACL. Advanced Orthopaedic Associates 2778 N. Webb Rd. The graft material may either be harvested from the patient's own body which is known as autograft or from a cadaver known as an allograft. Dr. Karkare is very knowledgeable, helpful, and caring. -, Ma C.B., Keifa E., Dunn W., Fu F.H., Harner C.D.
2011 Dec;39(12):2536-48). Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Been going to this place before my accident and after I had my knee surgery. 17. I thought for ACL repair you could only report the graft if it was harvested from the other leg. Short description: Mech compl of muscle and tendon graft, sequela The 2023 edition of ICD-10-CM T84.490S became effective on October 1, 2022. The BPTB graft along with the bony ends helps in the biological incorporation of the graft. Both autograft and allograft are safe options for ACL reconstruction but the ultimate decision for the graft type may depend upon the patients needs and anatomy. During the past decades, hamstring tendon (HT) and bone- patellar tendon (middle 1/3)-bone (BPTB) autografts are the most used grafts for ACL reconstruction. Intraoperative photograph (left leg) showing dissection of the gracilis from the sartorial fascia and from the semitendinosus, prior to harvesting. So about one month after our initial meeting I had the first knee done. (Battaglia TC, Arthroscopy. Anterior cruciate ligament graft placement recommendations and bone-patellar tendon-bone graft indications to restore knee stability. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. Graft options: Autograft patellar, hamstring, and quadriceps tendons. ACL surgery is defined by CPT 29888 (Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction). Total knee replacement was the only viable option. JavaScript is disabled. The allograft ACL reconstruction is also considered to be less strong than the autograft reconstruction. (Beynnon BD, Am J Sports Med. Advertisement Allograft types commonly used in ACL reconstruction include Achilles tendon (A), hamstring tendon (B) and patellar tendon (C). Your knee will be swollen, and you may have numbness around the incision on your knee. Complete Orthopedics should be your choice! government site. Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office.. Copyright 2023 Becker's Healthcare. All Rights Reserved. The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care". The torn ligament is removed from the knee before the graft is inserted through a hole created by a single incision. 3. He put in a rod and two screws in her hip. The ACL is located in the center of the knee joint where it runs from the backside of the femur (thighbone) to the front of the tibia (shinbone). Postoperative images showing quadriceps tendon autograft scar and range of motion. (Mather RC, JBJS 2013;95A:1751), at 11.5 year follow up: 7.0% graft failure forBPTB and HT autograft;Kellgren-Lawrence grade 2 arthritis found in 52.0% ofBPTB and 51.0% HT autograft patients (Belk, JW, Arthroscopy. Bookshelf Dr. Vaksha is awesome and takes the time to listen to his patients. Rose of NYU Langone Orthopedics demonstrates the surgical technique for harvesting hamstring tendon autografts for ACL reconstruction.Donald J.. Metso L, Bister V, Sandelin J, Harilainen A. BMC Surg. The tendons, harvested with an open-ended tendon stripper while their tibial insertions are preserved, are looped around to prepare a quadrupled graft. Bone-to-bone healing of BTB autografts can occur within 6 weeks. I highly recommend this office to anyone whos looking for knowledgeable and kind orthopedic office. Linking and Reprinting Policy. The quadrupled tendon has more strength than the natural ACL. Currently, CPT code 29876 bundles with 29888. T84.490S is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The ultimate goal of anterior cruciate ligament (ACL) reconstruction is the restoration of the native knee kinematics by replacing an injured ACL with a functional graft. Bethesda, MD 20894, Web Policies Am J Sports Med. In this case, we demonstrate with radiographic and arthroscopic evidence, a robustly healed ACL after repair with internal bracing. 16. When I see him he makes sure to review my progress in detail. The patellar tendon graft is the graft most commonly used by Dr. Kiritsis. Allografts in patients aged 30 or less have been associated with early graft failure. Participation in rehabilitation and general recovery is faster than autograft. This involves harvesting a piece of bone from the patella (kneecap), the central 1cm of the patellar tendon, and a piece of bone from the tibia to create the new ACL. Both surgeons are reimbursed 62.5 percent of the allowable for CPT 22558. 27,40 An undertensioned graft can be nonfunctional and lead to . Instr Course Lect. Cpt Code For Acl Reconstruction With Allograft PDF Download May . Although the technique of hamstring autograft harvest is relatively straightforward, it is critical to pay attention to several technical steps to avoid iatrogenic neurovascular damage as well as to avoid premature amputation of the graft while using a tendon stripper. A/P view: center of the tibial attachment should be just lateral to the exact center of the tibia. cpt code for open acl reconstruction with hamstring autograft. ACL reconstruction usually would be considered medically necessary and covered by health insurance. Anterior Cruciate Ligament (ACL) Repair with Allograft reconstruction is one of the most common procedures performed by orthopedic surgeons. .elizabeth .thank you so much . The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. The surgeon will also make another incision in the knee and insert the graft (replacement tissue). Am J Sports Med. Anterior Cruciate Ligament (ACL) Reconstruction with Allograft reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after Anterior Cruciate Ligament injury. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Anterior cruciate ligament reconstruction ( ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after anterior cruciate ligament injury. Drill endobutton tunnel with endobutton drill. Most of this swelling will go away in a few days, and you should soon start seeing improvement in your knee. Dissection to sartorius fascia, incise fascia just above Gracilis. full or partial thickness) grafts. ACL Reconstruction with Allograft or Hamstring Autograft: Post-op Protocol 2019-10-21T16:09:31-04:00. Hamstring tendon autograft remains a popular graft choice for anterior cruciate ligament (ACL) reconstruction. CPT Code: 29888. The location of the graft site may not help and cause morbidity. The staff is very professional and helpful. doi: 10.1016/j.eats.2019.09.021. I am so happy he is my doctor. He listens to everything and explains everything I recommend him to everyone. A local anesthetic completely blocks pain from your knee area and you will stay awake during the operation. If this is your first visit, be sure to check out the. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions. Comparison between early accelerated vs nonaccelerated rehabilitation programs demonstrate no differences in long-term results for function, reinjury, and successful return to play. Physician specialties with the happiest marriages, 'Like he was passing out candy': Former physician pleads guilty to fraud charges, 15 things to know about the 3 biggest ASC chains, New York physician sues employer for alleged bias. Patients will be prescribed to receive a soft tissue hamstring autograft to for ACL reconstruction. cpt code for open acl reconstruction with hamstring autograft. 2005;21:791803. Should we code the synovectomy procedure when surgeons perform the ACL repair during the same episode* 2005 Jun;21(6):767), average length of patellar tendon is 45mm but can vary up to 20mm. Insert sheath with derotation lab in 12 oclock position. You are using an out of date browser. One is a strip of the patellar tendon below the kneecap. If so, this should be done by direct communication with the therapist, or in writing on the . So happy how I been treated and how well I am getting. CPT Code: 29888 Anterior cruciate ligament reconstruction (ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after anterior cruciate ligament injury. 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference, 8th Annual Health IT + Digital Health + RCM Conference, 29th Annual Meeting - The Business & Operations of ASCs, 580+ ASCs with total joint replacements | 2023, State-by state breakdown of 2022's 183 new ASCs, 510 of America's 'Best' ASCs in 2023: Newsweek, UPMC, surgeon to pay $8.5M for allegedly performing multiple complex surgeries at once, ASCs' reimbursement woes: What's worrying leaders in 2023, UnitedHealthcare changes prior authorization requirements for GI care. This may be painful and may limit your athletic performance. Dr.Karkare is the best. Arthroscopic Reconstruction of ACL and LCL Tear with Combined Asymmetric Hamstring Graft Using Single Femoral Tunnel - A Case Report. Physicians see income drop what happens next? To me, the gold standard of ACL reconstruction is the patella tendon autograft and should be considered for most people in their teens, 20's and for many in their 30's or 40's. It is believed that the bone-patella tendon-bone graft has a stronger fixation because of the bone plugs that can incorporate into the . Graft excursion <2.5mm from full flexion to full extension. It may range from 4 to 6 months. . The surgeon inserts an arthroscope into one of the other incisions. Repeat injury to the graft (just like the original ligament). synonyms: ACL repair, ACL reconstruction, anterior cruciate reconstruction, ACL Reconstruction Pre-op Planning / Graft Considerations, ACL Bone-Patellar Tendon-Bone (BTB) Reconstruction Technique, Site Terms | Copyright Information | ContactUs | Site Registration.
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