Scope Essentials 2024-Managing bone loss and prior hardware in revision ACL Reconstruction

Managing bone loss and prior hardware in revision ACL Reconstruction

Video Transcription

Video Summary

Amanda One from Penn State discusses revision ACL reconstruction challenges, focusing on bone loss and prior hardware. Revision rates can reach 11-30%, especially in young athletes. Key issues include tunnel malposition, dilation, bone loss, and retained hardware. Determining the failure cause is crucial, often technical errors like incorrect tunnel placement. Decisions involve single- vs. two-stage revisions; two-stage is for severe tunnel widening (>15mm), infection, or range-of-motion loss. Techniques include bone grafting with dowels, tunnel dilators, and autograft use. Accurate tunnel placement relies on anatomical landmarks, fluoroscopy, and tools like rulers and grids. Metal screws and autografts improve outcomes.

Asset Caption

Aman Dhawan, M.D.

Keywords

Revision ACL reconstruction

Bone loss

Tunnel malposition

Two-stage revision

Bone grafting techniques