Two-Stage Anterior Cruciate Ligament Reconstruction Revision Surgery for Severe Bone Defects With Anterolateral Ligament Reconstruction Technique

Abstract

Anterior cruciate ligament revision surgery poses a number of specific difficulties. These include the lack of bone mass to enable effective fixation of the reconstruction, morbidity of the donor area when bone autograft is used to fill the tunnels, and absence of the semitendinosus and gracilis homolateral tendons in cases in which they have already been used in the primary surgical procedure. To address all these problems, we describe a 2-stage revision technique that uses bone allograft for tunnel filling and Achilles allograft for ligament reconstruction. In addition, the intervention includes an extra-articular phase in which the anterolateral ligament is reinforced to increase the rotational stability of the knee, thus improving the prognosis of operation.