Controversies in ACL revision surgery: Italian expert group consensus and state of the art.
J Orthop Traumatol
; 23(1): 32, 2022 Jul 15.
Article
em En
| MEDLINE
| ID: mdl-35840726
ABSTRACT
BACKGROUND:
Revision ACL reconstruction is a complex topic with many controversies and not-easy-to-make decisions. The authors' aim is to provide some feasible advice that can be applied in daily clinical practice with the goal of facilitating the decision-making process and improving the outcomes of patients subjected to revision ACL reconstruction.METHODS:
A national survey with seven questions about the most controversial topics in revision ACL reconstruction was emailed to members of two societies SIOT and SIAGASCOT. The participants' answers were collected, the most recent literature was analyzed, and a consensus was created by the authors, according to their long-term surgical experience.CONCLUSIONS:
The decision-making process in revision ACL reconstruction starts with a standardized imaging protocol (weight-bearing radiographs, CT scan, and MRI). One-stage surgery is indicated in almost all cases (exceptions are severe tunnel enlargement and infection), while the choice of graft depends on the previously used graft and the dimensions of the tunnels, with better clinical outcomes obtained for autografts. Additional procedures such as lateral extra-articular tenodesis in high-grade pivot-shift knees, biplanar HTO in the case of severe coronal malalignment, and meniscal suture improve the clinical outcome and should be considered case by case. LEVEL OF EVIDENCE V (Expert opinion).Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tenodese
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Reconstrução do Ligamento Cruzado Anterior
/
Lesões do Ligamento Cruzado Anterior
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article