ACL RECONSTRUCTION FAILURE
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This document discusses ACL reconstruction failure and revision surgery. It notes that instability, stiffness, and pain could indicate failure. The main causes of failure discussed are traumatic failure, biologic failure, and technical error, particularly malpositioned tunnels. It provides statistics on ACL reconstruction and failure rates. It highlights potential pitfalls in revision surgery like malpositioned tunnels, widened tunnels, soft tissue grafts, and fixation devices. The conclusion emphasizes that ACL revision is demanding, requires careful preoperative planning, and has lower success rates than primary ACL reconstruction. Experience is important for managing revision cases.
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ACL RECONSTRUCTION FAILURE
- 1. REVISION ACL Gonzalo Samitier MD PhD Orthopaedic Sports Medicine Fellow Henry Ford Health System RECONSTRUCTION FAILURE
- 4. + 6mm Pivot +2 or +3
- 5. - Surgery was totally a succes, everything looks fine … - I just wouldn’t recommend using that leg anymore or getting a second opinion from one of my partners …
- 8. …that’s Ok
- 9. So WHAT INSTABILITY STIFF PAIN … is this an ACL reconstruction Failure?
- 13. INSTABILITY Descriptive Epidemiology of the Multicenter ACL Revision Study (MARS) Cohort The MARS Group Am J Sports Med 2010 38: 1979
- 15. Biologic failure
- 16. “TUNEL MALPOSITION” Value 75% “OTHERS” Value 25% Technical error
- 17. Allograft source 7% Femoral fixation 6% Malalignment 4% Posterolateral laxity 4% Tibial fixation 1% Autograft source 1% Posteromedial laxity 2% Other “OTHERS” Value 25% Technical error
- 18. “TUNEL MALPOSITION” Value 75% Technical error
- 22. DOUBLE BUNDLE vs SINGLE BUNDLE
- 23. … moment of truth
- 24. VIDEO TECHNIQUE See Video at: https://www.youtube.com/channel/UCqppa1V7WkCjwj OFDClNFkg
- 25. PEARLS & PITFALLS • Malpositioned tunnels • Widened tunnels • Soft tissue grafts • Posterior wall fracture • Fixation devices • Primary surgery autograft • Throclear notch narrowing
- 26. CONCLUSIONS ACL REVISION is a demanding surgery PREOP PLANING is mandatory LOWER RESULTS than primary acl ANATOMIC reconstruction