Artelon Graft Augmentation in Revision Anterior Cruciate Ligament Reconstruction: Surgical Technique Guide

Revision anterior cruciate ligament (ACL) procedures are becoming more prevalent. Variable grafts for ACL reconstruction are available, including autograft, allograft, and synthetic graft options. Various augmentation techniques are also available and typically consist of synthetic material such as Artelon graft. This type of synthetic material has been used and shown to produce safe and reliable augmentation in ligament injuries. The purpose of this study was to describe our unique revision ACL reconstruction technique utilizing Artelon graft augmentation and report our short-term results.

We retrospectively reviewed patients undergoing revision ACL reconstruction with Artelon graft augmentation, a Flexband polyurethane-urea and polycaprolactone scaffold, to a tibialis anterior tendon allograft. We performed ACL reconstruction with Artelon graft augmentation utilizing the novel "ice cream sandwich" technique in both patients. Range of motion, return to activity, subjective pre- versus post-injury strength and stability, and Lysholm Knee Scores were evaluated with a 2-year follow-up.

Two patients met the inclusion criteria with an average age of 25.5 years (22-29 years). A 24-month follow-up was obtained for both patients through a telephone encounter. Lysholm Knee Scores were recorded for each patient, with an average score of 86, demonstrating a good outcome 2 years postoperatively. No reoperations or complications, including infection, failed reconstruction, or neurovascular injury, were recorded for either patient.

We described a novel technique for revision ACL reconstruction that is safe and provides good post-operative functional outcomes at short-term follow-up. With revision ACL reconstruction procedures on the rise, this is a safe technique that may assist with additional stability around the graft and can be considered in young active adults.