Revision Anterior Cruciate Ligament Reconstruction Surgery

Robert S. Wolf, MD, Lawrence J. Lemak, MD

Disclosures

J South Orthop Assoc. 2002;11(1) 

In This Article

Abstract and Introduction

Abstract

In 1995, it was reported that 60,000 to 75,000 anterior cruciate ligament (ACL) reconstructions were being performed annually in the United States. Successful long-term results are achieved in 75% to 95% of these patients, but 8% have unsatisfactory results due to recurrent instability and graft failure. With the increasing popularity of this procedure, ACL revision surgery has also become increasingly common. While the techniques described for ACL revision have been varied, the overall results in the literature do not compare favorably with primary ACL reconstruction. The proper execution of revision ACL reconstruction requires precise preoperative planning to assess the cause of initial failure and avoid repeating the same mistakes with revision reconstruction. Graft choice, hardware removal, revision notchplasty, tunnel placement, and method of fixation are key points for a successful result. The causes of ACL failure, the technical aspects of revision ACL surgery, and the reported results of revision ACL surgery are reviewed.

Introduction

Anterior cruciate ligament (ACL) reconstruction has become one of the more common procedures performed by orthopaedic surgeons over the past 10 years. In 1995, it was reported that an estimated 60,000 to 75,000 reconstructions were being performed annually in the United States.[1] While successful results are achieved in 75% to 95% of patients, 8% may experience unsatisfactory results due to recurrent instability and graft failure.[2,3] Thus, treatment of failed ACL reconstruction has become an increasingly pertinent topic, and the technical approaches to achieving a successful result have continued to evolve.

In this article, we discuss the classification and causes of ACL failure, the technical approaches to revision ACL reconstruction, and the reported results of revision ACL surgery.

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