Surgical Considerations in Revision ACL Reconstruction (AANA19)-Revision ACL Reconstruction_ Prep For Success And Role Of Extra-Articular Tenodesis-Dr. Michael J. Alaia, M.D.

Revision ACL Reconstruction_ Prep For Success And Role Of Extra-Articular Tenodesis-Dr. Michael J. Alaia, M.D.

Video Transcription

Video Summary

This comprehensive discussion focuses on ACL reconstruction and revision, highlighting failure rates, causes, and strategies for improvement. ACL revisions are more challenging with higher failure risks and lower return-to-sport rates, influenced by factors like surgical technique, graft choice, meniscus condition, and alignment. Critical errors include tunnel misplacement and failure to address collateral ligament injuries and tibial slope abnormalities. Thorough patient evaluation, imaging, and sometimes two-stage surgeries for bone grafting are essential for success. The speaker emphasizes understanding patient goals and tailoring treatment accordingly, including addressing meniscus and cartilage issues. Regarding rotational stability, anterolateral ligament (ALL) reconstruction and lateral extra-articular tenodesis may help, especially in high-grade pivot shifts or hyperlaxity, but evidence on their effectiveness, particularly in revisions, is limited. Complications such as stiffness and hardware problems exist. Ultimately, ACL failure is multifactorial, and these augmentations are just part of the puzzle requiring careful surgical planning and individualized treatment.

Asset Caption

Instructional Course Lecture: Surgical Considerations in Revision ACL Reconstruction

Keywords

ACL reconstruction

ACL revision

surgical technique

meniscus condition

anterolateral ligament reconstruction