While early graft failures (<3 months) are typically related to loss of fixation, sepsis, or aseptic biological reaction, more common are failures in the 3-12 month postoperative range which are often due to errors in surgical technique or aggressive physical therapy. We will also discuss our over-the-top technique and our recently described anatomical rectangular tunnel technique. All rights are reserved. © Springer Science+Business Media New York 2014. Skip to main content.sg. Skip to main content.sg. All rights are reserved. Multiple techniques for reconstructing the medial stabilizing complex have been described, including autograft as well as allograft type of tissue. In the United States alone, approximately 200,000 ACL ruptures and up to 175,000 reconstructions occur per year. Sport Specific Population. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. There has been a larger amount of research completed over the years regarding surgical techniques and rehabilitation after surgery, but prevention has been studied less. Two-stage revision anterior cruciate ligament reconstruction: indications, review, and technique demonstration. Concise chapters by a leading group of international orthopedic surgeons … 12.1 Posteroanterior flexion weightbearing ( a ) and lateral ( b ) X-rays of a left knee 11 years after ACL reconstruction showing vertical placement of the ACL tunnels with proximal positioning of suspensory fixation hardware and slight tunnel widening ( arrows ) Coats AC(1), Johnson DL. Anterior Cruciate Ligament reconstruction is a complex process, although the success rate of ACL reconstruction surgery is generally 85 – 95%. Isbn: 9781461407652. The opposite condition of our case about femoral condyle fracture is a complication of ACL reconstruction surgery but extremely rare [5]. Arthofibrosis after primary ACL surgery requiring revision of ACL graft following arthroscopic release and manipulation to restore full knee motion. Even though little evidence is available regarding high tibial osteotomy (HTO) and ACL revision, the importance of limb alignment is widely accepted, and even though HTO is almost never indicated in malaligned knees with acute ACL tear, malalignment is a widely recognized cause of ACL failure. and should be addressed for a successful ACL revision. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery, and complex technical considerations. Plus, free two-day shipping for six months when you sign up for Amazon Prime for Students. Purpose Clinical decision-making and technical considerations for repeat revision ACL reconstruction are the focus of this chapter. 443-56), or between 3 and 25 % of primary ACL reconstructions performed (Wolf and Lemak, J Southern Orthop Assoc 2002;11:25-32). All rights are reserved. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Reconstruction of the ACL is generally performed to restore stability and return the athlete to a healthy and active lifestyle. We recommend addressing tibial slope in patients with a posterior tibial slope greater than 13°who are undergoing revision ACL reconstruction. Preoperative consideration of each of the failure etiologies and possible surgical pitfalls will help minimize surgical complications, decrease operative time, and maximize postoperative outcomes. Injuries to the anterior cruciate ligament (ACL) are common throughout the athletic population starting as young as 6 years old. With a detailed history and physical examination, a thorough workup, and multiple backup options available, a successful revision surgery can be accomplished. Failure was determined as re-revision. Read Revision ACL Reconstruction: Indications and Technique book reviews & author details and more at Amazon.in. A search of the Danish Knee Ligament Reconstruction Registry identified 1619 revision ACLRs: 1315 were autograft procedures and 221 were allograft procedures (type of graft was not identified for 83 procedures). A number of technical factors can contribute to these results. Single Stage ACL Revision Reconstruction: Indications and Technique Fig. © Springer Science+Business Media New York 2014. Commonly accepted indications for concomitant ACL and ALL reconstruction are ACL revisions, high-grade pivot-shift test, chronic ACL rupture, and young patients and patients doing pivoting activities. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Each of these etiologies must be considered prior to surgery to optimize postoperative outcome. © 2008-2021 ResearchGate GmbH. Springer is part of, Innovative integrative multidisciplinary approach to revision ACL reconstruction, Provides case-based analysis of ACL revisions, including pitfalls and pearls, Cutting-edge developments for ACL revision surgeries are described by field-leading experts, ebooks can be used on all reading devices, Institutional customers should get in touch with their account manager, Usually ready to be dispatched within 3 to 5 business days, if in stock, The final prices may differ from the prices shown due to specifics of VAT rules. Account & Lists Account Returns & Orders. This chapter will focus on the indications and techniques for a two-staged technique for revision ACL reconstruction surgery utilizing a case-based approach. Fig. Osteotomy for Malalignment Following Failed ACL Reconstruction. Today, revision ACL reconstruction has changed considerably in line with the new paradigm of anatomic reconstructive techniques. The recorded number of ACL reconstructions in 1991 was approximately 63,000 cases (Brown and Carson, Clin Sports Med 1999;18:109-71). Anterior cruciate ligament (ACL) insufficiency may lead to post-traumatic arthritis due to altered joint loading and associated injuries to the menisci and articular cartilage. Failure to recognize and address a posterolateral corner injury may be a predisposing factor. There are many etiologies for failed ACL reconstruction. Preoperative planning for revision ACL reconstruction represents one of the most crucial steps to optimize postoperative outcomes. This chapter will focus on the indications and techniques for a two-staged technique for revision ACL reconstruction surgery utilizing a case-based approach. Understanding the importance of posterior tibial slope and its role in sagittal knee stability has led to the development of biplane osteotomies designed to flatten the posterior tibial slope in the ACL deficient knee. Advantages of CAS are especially important for complex scenarios as ACL revision surgery, due to the improvement of the accuracy that may potentially allow to customize the surgery for each patient to reduce the failures. springer, Although anterior cruciate ligament (ACL) reconstruction has a high success rate, a substantial number of patients are left with unsatisfactory results. INDICATIONS FOR ALLOGRAFT ACL RECONSTRUCTION I n the senior author’s (C.D.H.) Anterior cruciate ligament (ACL) reconstruction surgery is common and clinical outcomes are typically good. © Springer Science+Business Media New York 2014. All rights are reserved. Failure to address limb malalignment and concomitant ligamentous injuries may also contribute to ACL graft failure. All rights are reserved. Concise chapters by a leading group of international orthopedic surgeons … © Springer Science+Business Media New York 2014. 2014 by Marx, Robert G. (ISBN: 9781493952427) from Amazon's Book Store. INDICATIONS AND CONTRAINDICATIONS The medial portal technique is versatile and can be used with any ACL graft type and for any primary, revision, single- or double-bundle ACL reconstruction. © Springer Science+Business Media New York 2014. The goal of this chapter is to explore the role of tibial deflexion osteotomy in improving the outcome of revision ACL reconstruction. Although primary ACL reconstructions have been considered a successful operation, success rates have still only ranged from 75 to 97 %. (gross), © 2021 Springer Nature Switzerland AG. Treatment / Technique Methods Recurrent instability after ACL reconstruction is a multifactorial problem that can be simplified by considering the failure in two simple categories: traumatic and atraumatic failures. springer, Although anterior cruciate ligament (ACL) reconstruction has a high success rate, a substantial number of patients are left with unsatisfactory results. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Potential etiologies of failure include: technical failure, biologic failure, mechanical failure, and unrecognized concomitant injury. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Optimal graft fixation and healing is predicated on healthy, living bone of structural integrity at the aperture of the bone tunnel. Two-stage Revision Anterior Cruciate Ligament Reconstruction: Indications, Review, and Technique Demonstration Aaron C. Coats, MD; Darren L. Johnson, MD R evision anterior cruciate ligament (ACL) recon-struction is increasing in fre-quency. This procedure may improve outcomes in carefully selected patients, although current research is quite limited. Outcomes for revision were provided for the full life of the registry, up to 10 years. ACL revision reconstruction is occurring more frequently as the number of ACL reconstructions increases. Preparation is paramount to successful revision reconstruction, and multiple surgical strategies must be available at the time of surgery. © Springer Science+Business Media New York 2014. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. hit that Ward's is the not important book revision acl reconstruction indications and Following on conformational UsenetBucket, I focus surprisingly reported. ACL revision reconstruction is occurring more frequently as the number of ACL reconstructions increases. Introduction. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. This person is not on ResearchGate, or hasn't claimed this research yet. examination, a thorough workup, and multiple backup options available, a successful revision surgery can be accomplished. Relatively little attention has been paid to the influence of tibial slope on stability and the need for ACL revision. Proper tunnel positioning on the femoral and tibial sides is critically important, and tunnel malposition is the most common technical cause of graft failure. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery, and complex technical considerations. Abstract. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. PATIENT SELECTION A … Páginas: 273. Cart All. Errors in notchplasty can lead to graft failure, as well. This chapter discusses options for single stage revision surgery and the challenges associated with this surgery. Familiarity with the anatomy of this ligament alongside with recognizing and addressing dysfunction of this structure in the setting of ACL reconstruction is of major importance, and failure to do so can result in excessive valgus stress applied to the ACL graft, leading to graft failure. Free 2-day shipping. There has been limited investigation, however, into patient-related risk factors for re-tear of grafts following ACL reconstruction. Revision reconstruction of the anterior cruciate ligament (ACL) is becoming more frequent due to the increasing number of ACL primary reconstruction combined with the high level of activity expected by the patients. © Springer Science+Business Media New York 2014. All rights are reserved. All rights are reserved. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Author information: (1)Department of Orthopaedic Surgery, American Health Network, Indianapolis, Indiana, USA. Various factors influence the success or failure of primary ACL reconstruction. All rights are reserved. Although anterior cruciate ligament (ACL) reconstruction has a high success rate, a substantial numb.. Femoral tunnel malposition is a common situation in revision ACL reconstruction. The technique described below involves the use of an anterior closing-wedge osteotomy to decrease tibial slope. Revision surgery is technically more challenging due to many factors including limitations in graft choice, placement of previous bone tunnels, other concomitant knee injuries, chronicity of instability, possible development of degenerative changes, adhesions, and many others. ACL revision reconstruction is occurring more frequently as the number of ACL reconstructions increases. Although anterior cruciate ligament (ACL) reconstruction has a high success rate, a substantial number of patients are left with unsatisfactory results. Author information: (1)Department of Orthopaedic Surgery, American Health Network, Indianapolis, Indiana, USA. Despite the reported success of primary ACL reconstruction graft failures can occur. Despite the prevalence of revision ACL reconstruction, there is no universally agreed upon graft choice. Preparation is paramount to successful revision reconstruction, and multiple surgical strategies must be available at the time of surgery. The number of anterior cruciate ligament (ACL) reconstructions has increased substantially over the last 20 years (Lyman et al., J Bone Joint Surg Am 2009;91:2321-8). The medial collateral ligament (MCL) is the primary restraint to valgus stability of the knee. It also protects cartilage and menisci from secondary injuries. This chapter reviews activity level, sex, age, biomechanical factors, and neuromuscular control as risk factors for graft failure after primary ACL reconstruction. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery and complex technical considerations. Concise chapters by a leading group of international orthopedic surgeons … Return to sport following revision surgery is also affected by these factors and is less predictable than in the primary setting. They are predominantly anteriorly-proximally located by trans-tibial tunnel techniques for fear of posterior cortical blowout. Two-stage Revision Anterior Cruciate Ligament Reconstruction: Indications, Review, and Technique Demonstration Aaron C. Coats, MD; Darren L. Johnson, MD R evision anterior cruciate ligament (ACL) recon-struction is increasing in fre-quency. Philadelphia, PA: Saunders Elsevier; 2008. pp. Revision ACL Reconstruction: Indications and Technique. To investigate the clinical outcomes and failure rates of revision ACLRs performed with either allograft or autograft. All rights are reserved. ACL Revision Surgery: Guide for Orthopedic Surgeons. There is a relative paucity of guidance that can be gleamed from the literature and what does exist is fairly heterogeneous and difficult to interpret as a whole. Commonly accepted indications for concomitant ACL and ALL reconstruction are ACL revisions, high-grade pivot-shift test, chronic ACL rupture, and young patients and patients doing pivoting activities. Primary anterior cruciate ligament (ACL) reconstructions (ACLRs) are being performed with increasing frequency. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery and complex technical considerations. Two-stage revision anterior cruciate ligament reconstruction: indications, review, and technique demonstration. Køb Revision ACL Reconstruction som e-bog på engelsk til markedets laveste pris og få den straks på mail. REVISION ACL RECONSTRUCTION‚ Indications and technique Autor: Marx. Late failures are typically caused by trauma; a failure at any time may be multifactorial in nature. Hello Select your address All Hello, Sign in. Join ResearchGate to discover and stay up-to-date with the latest research from leading experts in, Access scientific knowledge from anywhere. ), Meniscus Allograft Transplantation in Revision ACL Reconstruction, Cartilage Surgery in Revision ACL Reconstruction, Medial Collateral Ligament Laxity in Revision ACL Reconstruction, Posterolateral Corner Deficiency in Revision ACL Reconstruction, Osteotomy for Slope Correction Following Failed ACL Reconstruction, Osteotomy for Malalignment Following Failed ACL Reconstruction, Navigation for Revision ACL Reconstruction, Approach to the Multiply Revised ACL-Deficient Knee. ACL Reconstruction Techniques •Until the 1970s, there was a significant controversy about the functional importance of the ACL •1970s: ACL repair –Not universally successful •Early 1980s: Repair with augmentation •Complete replacement of the ACL with a graft –Clancy: Bone Patella Tendon Bone (vascularized) •JBJS, 1982 The revision can be a straightforward surgery in cases with previously well-placed and anatomic bone tunnels or in cases where the bone tunnels are far from the native footprints. The basic technique for a two-stage bone grafting procedure involves clearing and identifying the ACL footprints and previous hardware on both tibia and femur, removing hardware as necessary, and bone grafting the previous tunnels using either allograft or autograft harvested from the iliac crest (stage 1). However, a minority of patients develop recurrent instability, necessitating revision surgery. Although infrequent, infection after ACL reconstruction is a potentially devastating complication. Although anterior cruciate ligament (ACL) reconstruction has a high success rate, a substantial number of patients are left with unsatisfactory results. Clinical outcomes after 1 year were reported via the Knee injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity score, and an objective knee stability measurement that determined side-to-side differences in instrumented sagittal knee laxity. ACL revision reconstruction is occurring more frequently as the number of ACL reconstructions increases. Post operatively, followed until 2 years and the result seem to be satisfactory. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Previous reports have presented femoral fractures occurring after ACL reconstruction and none have been during the revision procedure. author’s (C.D.H.) These include existing tunnel position, tunnel enlargement, presence of hardware, and graft selection for revision surgery. Articular cartilage lesions are commonly associated with anterior cruciate ligament (ACL) tears and are often encountered at the time of ACL revision surgery. Furthermore, ALL reconstruction techniques have evolved and indications extended. All rights are reserved. A proposed management algorithm is suggested, derived from the best available current evidence. Reconstruction of ACL recommended based on indication and its successful dependent on the pre operative until post operative management. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery, and complex technical considerations. Hello Select your address All Hello, Sign in. 1 While ACL reconstruction has a very high rate of success and patient satisfaction, there is a subset of reconstructions that fail. ACL Injury is a common case among knee injuries which relatively common in athletes and productive ages. This evidence-based review will cover the indications for two-stage revision ACL reconstruction, surgical techniques, evidence for bone grafting of prior ACL tunnels, and outcomes of twoof two-stage revision stratified by initial cause of ACL reconstruction failurestage revision stratified by initial cause of ACL reconstruction failure. All rights are reserved. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Cart All. However, the revision can also be a complex surgery with many pitfalls, thus the preoperative planning is imperative and every experienced knee surgeon must be prepared for a secondary plan. Several factors must be considered prior to surgery. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery, and complex technical considerations. Revision ACL Reconstruction: Indications and Technique: Marx, Robert G.: Amazon.com.au: Books All rights are reserved. As parallelepiped tunnels with a cross-sectional area of 50 mm2 in ART ACLR are smaller in aperture than 10-mm cylindrical tunnels with that of 79 mm2 in conventional techniques, the rectangular tunnels in revision ACLR may be less frequently compromised by non-anatomic previous tunnels. Generally, autografts are the preferred graft for revision ACL reconstructions due to their more rapid and complete incorporation into the host tissue, but allograft tissue is used if there are limited autograft options available or if autograft use is relatively contraindicated secondary to patellofemoral pathology. More than 200,000 anterior cruciate ligament (ACL) reconstructions are estimated to be performed annually in the United States. This technique allows to evaluate joint kinematics and laxities before performing the ACL revision, to check the placement and the isometry of the new tunnels. Read reviews from world’s largest community for readers. This chapter discusses options for single stage revision surgery and the challenges associated with this surgery. With a detailed history and physical. Free delivery on qualified orders. Surgical reconstruction aims to restore the stability in the knee, and to improve function and ability to partici …. Patients with an ACL injury commonly present to the sports orthopaedic surgeon. In an attempt to understand the risk factors for primary reconstruction failure and improve the outcomes of revision surgery, the Multicenter ACL Revision Study (MARS) was established in 2006. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Each of these factors should be addressed in the planning and execution of revision ACL reconstructions. Therefore, a significant number of patients who undergo ACL reconstruction may have a less than satisfactory outcome, leading to a revision ACL surgery. The purpose of this Technical Note is to describe our indications (Table 1) and technique (Video 1) for combined opening wedge HTO and ACL reconstruction. Up to 90% off Textbooks at Amazon Canada. © Springer Science+Business Media New York 2014. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. More than 200,000 anterior cruciate ligament (ACL) reconstructions are estimated to be performed annually in the United States. It seems that you're in France. Coats AC(1), Johnson DL. Simultaneous ACL reconstruction may require technique modifications depending on the type of HTO and ACL graft chosen. Evaluation under anesthesia is then undertaken when surgery is indicated, followed by arthroscopic evaluation to assess the amount of medial compartment gapping. Poor prior tunnel locations and tunnel expansion can complicate fixation of the graft in a revision setting, and thus the surgeon must be familiar with multiple different fixation methods, their advantages, disadvantages, and potential complications. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Anterior cruciate ligament tears are a devastating injury to athletes commonly encountered in pivoting and cutting sports. Everyday low prices and free delivery on eligible orders. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery, and complex technical considerations. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Buy Revision ACL Reconstruction: Indications and Technique by Marx, Robert G. online on Amazon.ae at best prices. The goals of revision anterior cruciate ligament (ACL) reconstruction are identical to the goals of primary reconstruction, i.e., to restore the native ACL dimensions, collagen orientation, and insertion sites, although a careful evaluation is required to identify contributing causes to graft failure that may require additional surgical consideration or management. Infection. Sport Specific Population. Cases that involve valgus malalignment with the appearance of valgus-thrust gait should not be overlooked, since correcting the alignment with an osteotomy should be considered as the first surgical step. Interested in research on Anterior Cruciate Ligament? Anterior cruciate ligament (ACL) revision reconstructions are likely to increase as the number of primary ACL reconstructions increases. This chapter discusses options for single stage revision surgery and the challenges associated with this surgery. Concomitant meniscal transplant. Numerous risk factors for primary ACL tear have been identified including sex, activity level, anatomic variables, and neuromuscular control. Stability can generally be restored, but the long-term function of the knee following revision reconstruction ultimately can be limited due to degenerative lesions and the onset of arthritis. This chapter will focus on the qualities of the different graft sources available (autografts, allografts, and synthetic grafts) along with the advantages and disadvantages of each option. Results However, it is fundamental to identify the cause of the failure of the initial procedure during the preoperative period, allowing for detailed planning of the revision surgery. preferred technique is anatomic single-bundle ACL-R using a bone-patellar tendon-bone autograft. No decision-making algorithms are available regarding tibial osteotomy and ACL revision and every case must be carefully studied and planned. Modes of atraumatic failure include failure of graft ligamentization or biologic failure of the tissue, associated posterior medial or lateral laxity, meniscal deficiency, bone tunnel widening or lysis and technical error. Pre-op CT scan, magnetic resonance imaging measurements, and intra-op measurement dictate the technique, single- or two-staged procedure, graft choice, and the possibility of using the previous tunnels or necessity of new ones. ACL revision reconstruction is occurring more frequently as the number of ACL reconstructions increases. In these scenarios, concurrent HTO and ACL recon-struction or revision can be indicated. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery and complex technical considerations. © Springer Science+Business Media New York 2014. While many of these will have successful outcomes, failures will occur in a subset of patients who will require revision ACLRs. All rights are reserved. All rights are reserved. Athletes returning to high-level pivoting and cutting sports should be counseled on the increased risk of graft failure. She had undergo an ACL reconstruction using hamstring autograft with transtibial technique because standard transportal technique could not be done due to position of the allograft and the implant. Concomitant cartilage lesions can affect outcome after ACL revision and should be addressed at the same time. For revision ACLR, it is important to avoid overlapping tunnels. ... 98 In general, MAT is indicated for younger patients with normal alignment and minimal chondrosis who have pain or in whom previous ACLRs have failed. © Springer Science+Business Media New York 2014. We discuss different repair strategies for cartilage injury and their implementation in the context of revision ACL reconstruction. The anterior cruciate ligament (ACL) is a fundamental structure in the knee. Find great deals for Revision ACL Reconstruction: Indications and Technique by Robert G. Marx: New. © Springer Science+Business Media New York 2014. Buy Revision ACL Reconstruction: Indications and Technique Softcover reprint of the original 1st ed.
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