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Chapter 5: Techniques For ACL Revision Reconstruction.

Michelle E Kew1, Mark D Miller, Brian C Werner

  • 1Department of Orthopaedics, University of Virginia, Charlottesville, VA.

Sports Medicine and Arthroscopy Review
|April 30, 2020
PubMed
Summary
This summary is machine-generated.

Revision anterior cruciate ligament (ACL) reconstruction is increasingly common due to graft ruptures. Preoperative evaluation and surgical techniques aim to improve outcomes, though challenges remain.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomedical Engineering

Background:

  • Anterior cruciate ligament (ACL) reconstruction is a frequent orthopedic procedure.
  • Increasing ACL reconstruction rates lead to a rise in revision surgeries.
  • Graft rupture causes for revision ACL reconstruction are multifactorial.

Purpose of the Study:

  • To outline the preoperative evaluation for revision ACL reconstruction.
  • To describe surgical techniques for revision ACL reconstruction.
  • To review current outcomes and emerging research in revision ACL reconstruction.

Main Methods:

  • Detailed patient history and physical examination.
  • Radiographic imaging, including MRI and CT scans, for graft integrity and bone tunnel assessment.
  • Surgical intervention involving 1-stage or 2-stage procedures, potentially with bone grafting.

Main Results:

  • Revision ACL reconstruction presents unique challenges compared to primary procedures.
  • Preoperative imaging is crucial for identifying graft failure, associated injuries, and bone loss.
  • Surgical techniques vary, including single or double-stage approaches and management of concomitant injuries.

Conclusions:

  • Comprehensive preoperative assessment is vital for successful revision ACL reconstruction.
  • While outcomes can be poorer than primary ACL reconstruction, ongoing research offers hope for improvement.
  • Novel surgical techniques and rehabilitation protocols are essential for optimizing patient recovery and function.