AOSSM/AANA Specialty Day 2020-Revision ACL Surgery_ Technical Considerations for Success

Revision ACL Surgery_ Technical Considerations for Success

Video Transcription

Video Summary

Mark Miller discusses revision ACL reconstruction, focusing on causes of graft failure, especially tunnel widening (osteolysis). Proper initial tunnel placement and technique are critical to avoid failure. Revision surgery often requires addressing osteolytic tunnels with bone dowels, which offer good integration and biomechanical support. One-stage revision is possible if tunnels are under 14 mm without significant overlap; otherwise, a two-stage approach is necessary. CT imaging aids planning and assessment. Histology shows bone dowels integrate well over time, unlike some calcium phosphate implants. Future studies will compare materials and outcomes. Overall, thorough planning and addressing tunnel issues are key to successful revision ACL reconstruction.

Keywords

Revision ACL reconstruction

Graft failure causes

Tunnel widening osteolysis

Bone dowels integration

One-stage vs two-stage revision