Surgical Technique for Revision of Anterior Cruciate Ligament Reconstruction, Combined with Postero-Lateral Corner and Anterolateral Ligament Reconstruction Using the Same Femoral Tunnel for Reconstruction of These Structures

Abstract

Objectives The reconstruction of the anterior cruciate ligament (ACL) is the most performed knee surgery in Brazil; consequently, the number of failures in this reconstruction has increased. Each year, the exponential rise in ACL revision surgeries is linked to undiagnosed and untreated injuries. Possible causes of failures should be assessed, including the size and positioning of femoral and tibial tunnels, neglected ligament and meniscal injuries, rotational instabilities, and axis deviations. This article aims to describe a surgical technique for revising ACL reconstruction, associated with the posterolateral corner and anterolateral ligament, using the same femoral tunnel with autograft. Therefore, the article emphasizes the importance of preoperative diagnosis and the treatment of meniscal and ligament injuries associated with ACL injury. This new technique proves to be reliable, easily reproducible, providing adequate stability, reducing the number of femoral tunnels, and minimizing the chance of tunnel convergence, utilizing autologous grafts. Methods description of Surgical Technique for Revision of Anterior Cruciate Ligament Reconstruction, Combined with Posterolateral Corner and Anterolateral Ligament Reconstruction Using the Same Femoral Tunnel for Reconstruction of These Structures. Results Patients who underwent ACL revision with the technique described presented adequate anterolateral and rotational stability, compared to other reconstruction techniques of the posterolateral corner and anterolateral ligament. Conclusion The surgical technique described above generated stability in the revision of the ACL, as it was associated with simple peripheral ligament reconstruction using autologous tendons. This new technique appears to be reliable, easy to reproduce, generating adequate stability, thus reducing the number of femoral tunnels and the chance of confluence of these tunnels.