Current Trends and Indications for Extra-Articular Reconstruction in Revision ACL Reconstruction: A Cross-Sectional...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Reconstructive Surgery

Background:

• Revision anterior cruciate ligament reconstruction (ACLR) presents complex challenges in graft selection and anterolateral complex (ALC) augmentation.
• Clinical practice patterns for revision ACLR show significant variability among surgeons.

Purpose of the Study:

• To evaluate current trends in revision ACLR practices.
• To assess indications for ALC augmentation, preferred augmentation techniques, and graft type selection.

Main Methods:

• A cross-sectional survey study (Level of evidence, 3) was distributed to members of the American Orthopaedic Society for Sports Medicine (AOSSM).
• The survey comprised 12 questions on revision ACLR and demographics, with descriptive statistics used for analysis.

Main Results:

• The autograft patellar tendon was the most common graft (47%), followed by the quadriceps tendon (22%).
• Anterolateral complex (ALC) augmentation was utilized by 70% of respondents, primarily for multiple previous ACLR failures.
• Lateral extra-articular tenodesis (LET) was the preferred augmentation technique (80%) over anterolateral ligament reconstruction (ALL).

Conclusions:

• Revision ACLR practices lack a uniform consensus on graft choice and ALC augmentation indications.
• Lateral extra-articular tenodesis (LET) is the preferred augmentation technique, and autograft patellar tendon is the most utilized graft.
• Further studies are required to define optimal indications for augmentation and graft selection to improve revision ACLR outcomes.