BookMichael J. Alaia, Kristofer J. Jones, editors.
Summary: Anterior cruciate ligament reconstruction is one of the most common procedures performed in sports medicine centers. However, these procedures can carry a long-term failure rate as high as 5-15%%, and when these procedures fail, revision is significantly more complex. Considerable factors need to be assessed in patients that are indicated for surgery, as revisions carry a higher failure rate and potentially less optimal outcomes and return to sport and activity. These factors include, but are not limited to, the status of the meniscus, overall alignment, graft options, placement of prior implants or tunnels, collateral ligament quality, and whether or not the revision must be staged into two procedures. This text provides a comprehensive, case-based presentation of the most efficient and practical treatment algorithms for patients in need of revision ACL repair and reconstruction. Opening chapters discuss the initial patient work-up, radiography, surgical indications, graft options, and pre-operative considerations and preparations. The main portion of the book then describes both common factors leading to revision surgery as well as the surgical techniques themselves, illustrated via plentiful operative photos and vivid clinical case material. The management of osteolysis, ligamentous laxity, extra-articular tenodesis, plane correction, and meniscus deficiency, among others, are discussed in detail. Special populations, such as the pediatric patient, the elite athlete and the female athlete, are discussed as well. Shedding light on this challenging surgical repair, Revision Anterior Cruciate Ligament Reconstruction is the go-to resource for sports medicine and orthopedic surgeons, knee specialists and residents and fellows in these areas. .
Contents:
Initial Work-up of the Failed ACL Reconstruction
Radiographic Work-up of the Failed ACL Reconstruction
Indications for Revision ACL Reconstruction
Graft Options in the Revision ACL Setting
Management of the Structurally Intact ACL with Residual Instability
Management of Osteolysis in Revision ACL
Prior Femoral Tunnel Management
Prior Tibial Tunnel Management
Indications for Two-stage Revision ACL Reconstruction
Management of Medial Sided Ligamentous Laxity
Management of Lateral Sided Ligamentous Laxity
Management of Sagittal Plane Deformity
Role of High Tibial Osteotomy to Restore Coronal Balance
Role of Extra-articular Tenodesis: ITB
Role of Extra-articular Tenodesis: ALL
Management of the Medial Meniscus-deficient Knee
Management of the Lateral Meniscus-deficient Knee
Management of the Stiff Failed ACL Reconstruction
Management of the Failed Pediatric ACL Reconstruction
Concomitant Chondral Restoration
Management of the Elite Athlete with a Failed ACL Reconstruction
Outcomes after Revision ACL Reconstruction.