Fig 11.

Intra-articular stage and subsequent tibial fixation. (A) Fixation procedure for Achilles graft in tibia. An impactor (I) is used to secure the tibial end of the reconstruction. The bone block (II) provides a stable and natural fixation. In the illustration, one can see how the allograft exits through the lateral aspect of the femur and across the iliotibial band (III) before being introduced again under it to its definitive fixation place in the proximal tibia. (B) Intraoperative clinical image showing impaction of Achilles bone plug in distal tibial tunnel. An impactor (I) is used to secure the tibial end of the reconstruction. The bone block (II) provides a stable and natural fixation without the need for surgical implants.