2023 Specialty Day Access Pass-When to Graft, When to Stage

Video Transcription

Video Summary

Dr. Mike Zichilli discusses revision ACL reconstruction, emphasizing that only 10-15% require grafting despite 40-80% having tunnel issues. Successful revision relies on precise tunnel placement, with autografts preferred due to lower failure rates and better outcomes. Staging procedures are crucial when tunnel aperture is compromised or when addressing comorbid injuries like meniscal tears or bony deformities, as two-stage approaches outperform single-stage revisions. Shared decision-making is important, balancing ideal treatment with patient constraints. Techniques like bone dowels and suture anchor fixation improve stability in challenging cases. Early, comprehensive surgical planning maximizes the chance for successful ACL revision outcomes.

Asset Caption

Michael A. Zacchilli, M.D.

Keywords

revision ACL reconstruction

tunnel placement

autografts

two-stage procedures

shared decision-making