2023 Specialty Day Access Pass-Disasterplasty: Revision ACL and Multiligament Reconstruction

Video Transcription

Video Summary

This session discusses complex knee injuries and their management. The first case involves an 18-year-old Division 1 tennis player with a traumatic knee injury featuring complete tears of the ACL, PCL, MCL, and meniscus root avulsion. Treatment included a one-stage reconstruction using autografts (quadriceps for ACL), MCL repair augmented with Achilles allograft, PCL single-bundle reconstruction, and meniscus root repair. Early mobilization and use of Losartan were mentioned to reduce post-op stiffness. Despite stiffness requiring arthrolysis, the athlete showed improvement and return to play.<br /><br />The second case is a 30-year-old male with chronic instability after prior four-ligament reconstruction and tibial tunnel osteolysis. Management included staged treatment starting with a custom high tibial opening wedge osteotomy to correct alignment and reduce varus thrust. Post-op, the patient had improved pain, gait, and function, potentially avoiding further ligament surgery. The discussion emphasized careful planning to avoid overcorrection, consideration of dual-level osteotomy, and patient-specific graft choice and timing.

Asset Caption

Moderators: Michael J. Alaia, M.D., Cassandra A. Lee, M.D.
Panel: Tamara A. Scerpella, M.D., Jonathan F. Dickens, M.D., L.T.C., M.C., Bruce A. Levy, M.D., Armando F. Vidal, M.D.

Keywords

complex knee injuries

ACL PCL MCL tears

meniscus root avulsion

ligament reconstruction

high tibial osteotomy