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Published on: March 26, 2015
Single Stage Revision Anterior Cruciate Ligament Reconstruction through Anterolateral Tunnel in a Significantly
Sujit Jos1, Athish Jaims1, Prannoy Paul1
1Department of Orthopedic Surgery, M.O.S.C Medical College Hospital, Ernakulam, Kerala, India.
Introduction:
Multiple options are available for revising a failed anterior cruciate ligament (ACL) reconstruction. A staged procedure is considered only if there is significant tunnel widening. Here, we present a case of revision ACL reconstruction done in single sitting in spite of a widened tibial tunnel of 15.9 mm through an anterolateral tibial tunnel using a peroneus graft.
Case Report:
A 39-year-old male manual laborer with post-polio residual paralysis in the opposite leg with past history of trans-portal ACL reconstruction 11 years back using an ipsilateral hamstring graft presented to us with complaints of instability and swelling of the left knee following a slip and fall 2 months back. Magnetic resonance imaging showed a tear in the reconstructed ACL graft with cyclops and tibial tunnel widening of 15.9 mm. The patient underwent single stage revision ACL reconstruction through the anterolateral tibial tunnel using a peroneus longus tendon autograft. At 1 year follow-up, the patient has good knee movements with no signs of instability.
Conclusion:
Single stage revision ACL reconstruction through the anterolateral tibial tunnel in a case of significantly widened tibial tunnel gives satisfactory results similar to anteromedial tibial tunnel with advantages of not requiring a second surgery, faster recovery, and good bone for the tunnel compared to the previous medial tunnel.
