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