Revision anterior cruciate ligament reconstruction

• Published in: The bone & joint journal Vol. 105-B; no. 5; pp. 474 - 480
• Main Authors: Inclan, Paul M, Brophy, Robert H
• Format: Journal Article
• Language: English
• Published: England 01.05.2023
• Subjects: Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction - methods; Humans; Knee Joint - surgery; Reoperation - methods
• ISSN: 2049-4394; 2049-4408
• DOI: 10.1302/0301-620X.105B5.BJJ-2022-1064.R1

Anterior cruciate ligament (ACL) graft failure from rupture, attenuation, or malposition may cause recurrent subjective instability and objective laxity, and occurs in 3% to 22% of ACL reconstruction (ACLr) procedures. Revision ACLr is often indicated to restore knee stability, improve knee function, and facilitate return to cutting and pivoting activities. Prior to reconstruction, a thorough clinical and diagnostic evaluation is required to identify factors that may have predisposed an individual to recurrent ACL injury, appreciate concurrent intra-articular pathology, and select the optimal graft for revision reconstruction. Single-stage revision can be successful, although a staged approach may be used when optimal tunnel placement is not possible due to the position and/or widening of previous tunnels. Revision ACLr often involves concomitant procedures such as meniscal/chondral treatment, lateral extra-articular augmentation, and/or osteotomy. Although revision ACLr reliably restores knee stability and function, clinical outcomes and reoperation rates are worse than for primary ACLr.