Revision anterior cruciate ligament reconstruction: Preoperative assessment and planning

N. A. Mall, C. S. Gill, R. W. Wright

Research output: Contribution to journalArticle

Abstract

The anterior cruciate ligament (ACL) is essential for proper knee mechanics and failure to restore these mechanics following ACL reconstructions can lead to intra-articular pathology, stiffness, graft failure, or early arthritis. Moreover, failure to accurately diagnose and treat the cause of the ACL reconstruction failure can lead to poor results with revision surgery. The incidence of graft rupture is similar to that of the contralateral native ACL, and thus, other causes of graft failure should be investigated, including: graft impingement, poor graft incorporation, malpositioning of the graft, or failure to address secondary knee stabilizers at the time of surgery. Loss of motion, extensor mechanism dysfunction, and arthritis can cause poor outcomes in ACL reconstruction surgery, which may necessitate revision surgery. Proper history, including previous operative notes and arthroscopic pictures as well as comprehensive radiographic evaluation can help to elucidate the cause of failure as well as corrective surgical approaches. Selection of a graft for revision surgery can be complex and must require an informed discussion with the patient. Special considerations must be made regarding operative technique and graft fixation in the revision setting. ACL revision surgery is technically demanding and achieving good outcomes can be challenging; therefore, a thorough preoperative plan is essential for maximizing patient satisfaction and restoring proper knee mechanics to minimize risk of future knee pathology.

Original languageEnglish (US)
Pages (from-to)331-340
Number of pages10
JournalMinerva Ortopedica e Traumatologica
Volume60
Issue number4
StatePublished - Aug 1 2009
Externally publishedYes

Fingerprint

Anterior Cruciate Ligament Reconstruction
Transplants
Reoperation
Anterior Cruciate Ligament
Knee
Mechanics
Arthritis
Pathology
Patient Satisfaction
Rupture
Joints
History
Incidence

Keywords

  • Anterior cruciate ligament surgery
  • Patient care planning
  • Reoperation

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Revision anterior cruciate ligament reconstruction : Preoperative assessment and planning. / Mall, N. A.; Gill, C. S.; Wright, R. W.

In: Minerva Ortopedica e Traumatologica, Vol. 60, No. 4, 01.08.2009, p. 331-340.

Research output: Contribution to journalArticle

@article{06d7373d8d3943f5a5653c81bbf4011a,
title = "Revision anterior cruciate ligament reconstruction: Preoperative assessment and planning",
abstract = "The anterior cruciate ligament (ACL) is essential for proper knee mechanics and failure to restore these mechanics following ACL reconstructions can lead to intra-articular pathology, stiffness, graft failure, or early arthritis. Moreover, failure to accurately diagnose and treat the cause of the ACL reconstruction failure can lead to poor results with revision surgery. The incidence of graft rupture is similar to that of the contralateral native ACL, and thus, other causes of graft failure should be investigated, including: graft impingement, poor graft incorporation, malpositioning of the graft, or failure to address secondary knee stabilizers at the time of surgery. Loss of motion, extensor mechanism dysfunction, and arthritis can cause poor outcomes in ACL reconstruction surgery, which may necessitate revision surgery. Proper history, including previous operative notes and arthroscopic pictures as well as comprehensive radiographic evaluation can help to elucidate the cause of failure as well as corrective surgical approaches. Selection of a graft for revision surgery can be complex and must require an informed discussion with the patient. Special considerations must be made regarding operative technique and graft fixation in the revision setting. ACL revision surgery is technically demanding and achieving good outcomes can be challenging; therefore, a thorough preoperative plan is essential for maximizing patient satisfaction and restoring proper knee mechanics to minimize risk of future knee pathology.",
keywords = "Anterior cruciate ligament surgery, Patient care planning, Reoperation",
author = "Mall, {N. A.} and Gill, {C. S.} and Wright, {R. W.}",
year = "2009",
month = "8",
day = "1",
language = "English (US)",
volume = "60",
pages = "331--340",
journal = "Minerva Ortopedica e Traumatologica",
issn = "0394-3410",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "4",

}

TY - JOUR

T1 - Revision anterior cruciate ligament reconstruction

T2 - Preoperative assessment and planning

AU - Mall, N. A.

AU - Gill, C. S.

AU - Wright, R. W.

PY - 2009/8/1

Y1 - 2009/8/1

N2 - The anterior cruciate ligament (ACL) is essential for proper knee mechanics and failure to restore these mechanics following ACL reconstructions can lead to intra-articular pathology, stiffness, graft failure, or early arthritis. Moreover, failure to accurately diagnose and treat the cause of the ACL reconstruction failure can lead to poor results with revision surgery. The incidence of graft rupture is similar to that of the contralateral native ACL, and thus, other causes of graft failure should be investigated, including: graft impingement, poor graft incorporation, malpositioning of the graft, or failure to address secondary knee stabilizers at the time of surgery. Loss of motion, extensor mechanism dysfunction, and arthritis can cause poor outcomes in ACL reconstruction surgery, which may necessitate revision surgery. Proper history, including previous operative notes and arthroscopic pictures as well as comprehensive radiographic evaluation can help to elucidate the cause of failure as well as corrective surgical approaches. Selection of a graft for revision surgery can be complex and must require an informed discussion with the patient. Special considerations must be made regarding operative technique and graft fixation in the revision setting. ACL revision surgery is technically demanding and achieving good outcomes can be challenging; therefore, a thorough preoperative plan is essential for maximizing patient satisfaction and restoring proper knee mechanics to minimize risk of future knee pathology.

AB - The anterior cruciate ligament (ACL) is essential for proper knee mechanics and failure to restore these mechanics following ACL reconstructions can lead to intra-articular pathology, stiffness, graft failure, or early arthritis. Moreover, failure to accurately diagnose and treat the cause of the ACL reconstruction failure can lead to poor results with revision surgery. The incidence of graft rupture is similar to that of the contralateral native ACL, and thus, other causes of graft failure should be investigated, including: graft impingement, poor graft incorporation, malpositioning of the graft, or failure to address secondary knee stabilizers at the time of surgery. Loss of motion, extensor mechanism dysfunction, and arthritis can cause poor outcomes in ACL reconstruction surgery, which may necessitate revision surgery. Proper history, including previous operative notes and arthroscopic pictures as well as comprehensive radiographic evaluation can help to elucidate the cause of failure as well as corrective surgical approaches. Selection of a graft for revision surgery can be complex and must require an informed discussion with the patient. Special considerations must be made regarding operative technique and graft fixation in the revision setting. ACL revision surgery is technically demanding and achieving good outcomes can be challenging; therefore, a thorough preoperative plan is essential for maximizing patient satisfaction and restoring proper knee mechanics to minimize risk of future knee pathology.

KW - Anterior cruciate ligament surgery

KW - Patient care planning

KW - Reoperation

UR - http://www.scopus.com/inward/record.url?scp=73349104137&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73349104137&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:73349104137

VL - 60

SP - 331

EP - 340

JO - Minerva Ortopedica e Traumatologica

JF - Minerva Ortopedica e Traumatologica

SN - 0394-3410

IS - 4

ER -