Re-Revision ACLR: Operative Considerations.

Video journal of sports medicine Pub Date : 2025-06-19 eCollection Date: 2025-05-01 DOI:10.1177/26350254241303559
Hansel Ihn, Elaine Shing, Travis Maak
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Abstract

Background: Re-revision anterior cruciate ligament reconstruction (ACLR) is a challenging clinical problem. A multifactorial approach to this situation is necessary to address each patient's needs fully.

Indications: Persistent instability.

Technique description: Contralateral bone-patellar tendon-bone ACLR with tibial bone defect bone grafting and postfixation of the tibial bone plug. Concomitant lateral extra-articular tenodesis was also performed.

Results: At the 12-week follow-up, the patient had regained full range of motion and demonstrated sagittal stability on examination. However, with published data consistently demonstrating low return to preinjury level of activity, we remain cautiously optimistic with regard to her eventual outcome.

Discussion/conclusion: While it is important to be privy to the latest literature, it is also important to consider each patient's case individually. Consideration should be given to the patient's pertinent history and physical examination findings and not just radiographic parameters. Revision situations often present unforeseen challenges, so it is important to have contingency plans in place. Adopting techniques that minimize potential challenges, such as tunnel convergence, can be critical in successfully completing a surgery.

Patient consent disclosure statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

重新修订ACLR:手术考虑。
背景:前交叉韧带重建术(ACLR)是一个具有挑战性的临床问题。有必要对这种情况采取多因素方法,以充分解决每个患者的需求。适应症:持续不稳定。技术描述:对侧骨-髌腱-骨ACLR伴胫骨骨缺损植骨及胫骨骨栓后固定。同时行外侧关节外肌腱固定术。结果:在12周的随访中,患者恢复了全活动范围,并在检查中显示了矢状位稳定性。然而,已发表的数据一致表明,恢复到损伤前的活动水平很低,我们对她的最终结果保持谨慎乐观。讨论/结论:虽然了解最新的文献很重要,但单独考虑每个病人的情况也很重要。应考虑患者的相关病史和体格检查结果,而不仅仅是影像学参数。修订情况经常会出现不可预见的挑战,因此制定应急计划是很重要的。采用尽可能减少潜在挑战的技术,如隧道收敛,是成功完成手术的关键。患者同意披露声明:作者证明已获得本出版物中出现的任何患者的同意。如果患者的身份是可识别的,作者必须在提交的文件中附上患者的免责声明或其他书面批准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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