Challenges in Revision ACL Reconstruction (AANA25)-Considerations and Challenges in Revision ACL Reconstruction

Video Transcription

Video Summary

The discussion centered on revising ACL reconstruction, highlighting the complexity and difficulty of such procedures, particularly in cases of failed primary ACL reconstructions. The panel included experts such as Dr. Waterman, Dr. Sherman, Dr. Edgar, and Dr. Newell, along with Dr. Dewan and Dr. Arciero. They discussed topics ranging from evaluation and workup, tunnel malposition, osseous considerations, extra-articular procedures, and osteotomy to manage symptoms and prevent re-injury. The experts stressed the importance of thorough patient interaction, obtaining previous surgical records, and conducting comprehensive physical examinations and imaging. Dr. Dewan emphasized that the function of the lateral side of the knee is more than just the ALL; it also involves the iliotibial band complex, which contributes significantly to rotational stability. Other experts touched on complications like bone tunnel blowouts, interference screw issues, and the placement of various grafts, such as quad, hamstring, and BTB. The importance of LET (lateral extra-articular tenodesis) in revision cases was also highlighted to enhance rotational stability and reduce re-rupture risk. Audience questions focused on nuanced conditions like meniscus pathology and slope issues, contributing to the multifaceted conversation. The overarching theme was the need for recognizing and repairing concomitant injuries and ensuring precise surgical techniques to enhance success rates and patient outcomes in revision ACL reconstruction.

Asset Caption

Aman Dhawan, M.D. | Brian R. Waterman, M.D., FAANA | Seth L. Sherman, M.D., FAANA | Jonathan F. Dickens, M.D., COL, USAR | Clayton W. Nuelle, M.D., FAANA

Keywords

ACL reconstruction

revision surgery

tunnel malposition

osseous considerations

extra-articular procedures

osteotomy

lateral stability

iliotibial band

LET

graft placement

meniscus pathology

surgical techniques