Full Description
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, surgicalindications, 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.
