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

Video Transcription

Video Summary

Dr. Mike Zichilli from Northwell Lenox Hill discussed the topic of when to graft and when to stage revision ACL reconstruction. He highlighted the importance of considering tunnel position and fixation issues, as well as common tunnel problems in revision ACL cases. Dr. Zichilli emphasized that one revision is better than multiple revisions and that autografts are generally better than allografts. He also discussed the significance of considering the size and position of tunnels and apertures in grafting procedures. Comorbid injuries, such as meniscus tears, varus alignment, and tibial slope, were also addressed. Staging procedures were shown to have better outcomes than single-stage procedures. Biomechanical research supported the use of bone dowels for stability, and in cases where single-stage grafting was preferred despite challenges, calcaneal bone blocks were mentioned as a potential solution. No credits were given in the transcript.

Asset Caption

Michael A. Zacchilli, M.D.

Keywords

ACL reconstruction

grafting

revision ACL

tunnel position

fixation issues