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Revision ACL-Based Multiple-Ligament Knee Surgery

  • Theodore S. Wolfson
  • Mathew John Hamula
  • Michael J. AlaiaEmail author
Chapter

Abstract

The failed anterior cruciate ligament reconstruction is a particularly challenging topic for the sports medicine surgeon. Aside from the potentially complex technical facets of these cases, decision-making can be a difficult process with many variables for the surgeon to consider. Additionally, with results inferior to that of primary reconstruction, these are troublesome procedures for patients as well. Adding to the challenge of these cases is their intimate association with collateral or posteromedial/posterolateral corner insufficiency. Proper recognition and treatment of these complex injury patterns is of the utmost importance in optimizing the outcome for the patient with the failed anterior cruciate ligament reconstruction. This chapter will discuss the many issues with revision ACL reconstruction and offer tips to address revisions with collateral ligament and posteromedial/posterolateral corner involvement.

Keywords

Anterior cruciate ligament Revision ACL ACL reconstruction Failed ACL evaluation Posterolateral corner Posteromedial corner Varus instability Medial collateral ligament Multiligament knee injury Knee instability 

Abbreviations

3D-CT

Three-dimensional computed tomography

ACL

Anterior cruciate ligament

ACLR

Anterior cruciate ligament reconstruction

ALL

Anterolateral ligament

ALRI

Anterolateral rotatory instability

AMRI

Anteromedial rotatory instability

BMAC

Bone marrow aspirate concentrate

BPTB

Bone patellar tendon bone

CT

Computed tomography

DB

Double bundle

HTO

High tibial osteotomy

ITB

Iliotibial band

LET

Lateral extra-articular tenodesis

MARS

Multicenter ACL revision study

MCL

Medial collateral ligament

MLK

Multiligament knee

MOON

Multicenter orthopedic outcomes network

MRI

Magnetic resonance imaging

OTT

Over-the-top

PCL

Posterior cruciate ligament

PLC

Posterolateral corner

PMC

Posteromedial corner

PRO

Patient-reported outcome

PRP

Platelet-rich plasma

PTS

Posterior tibial slope

ROM

Range of motion

SB

Single bundle

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Theodore S. Wolfson
    • 1
  • Mathew John Hamula
    • 1
  • Michael J. Alaia
    • 2
    Email author
  1. 1.Department of Orthopedic SurgeryNYU Langone Orthopedic HospitalNew YorkUSA
  2. 2.Department of Orthopedic SurgeryNYU Langone Medical CenterNew YorkUSA

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