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The Role of Lateral Extra-articular Augmentation in Revision ACL Reconstruction

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Revision ACL Reconstruction

Abstract

While anterior cruciate ligament (ACL) reconstruction frequently results in a stable knee and return to high-level function, results of revision ACL reconstruction lag behind those of primary ACL reconstruction. Patients undergoing revision procedures may benefit from the increased rotational control afforded by lateral extra-articular augmentation of intra-articular grafts. The procedure described in this chapter includes an intra-articular reconstruction with patellar tendon graft and an associated extra-articular augmentation with gracilis tendon. Allograft or autograft tissue can be chosen. Fixation of the extra-articular augmentation is performed by looping the graft through the bone lock of the intra-articular graft on the femoral side and though a drill hole in Gerdy’s tubercle on the tibial side. Reported outcomes are variable, but lateral extra-articular augmentation has been shown in some series to decrease anterolateral rotational laxity more effectively than isolated intra-articular reconstructions. Augmentation is contraindicated in patients with posterolateral corner injuries. More work is required to completely define indications in the revision ACL setting.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, The Ohio State University Medical Center, 2050 Kenny Road, Pavilion Suite 3100, Columbus, OH, 43221, USA

    Robert A. Magnussen MD

  2. Department of Orthopaedic Surgery, CHU Lyon Croix Rousse, 103 Grande rue de la Croix Rousse, Lyon, 69004, France

    Sebastien Lustig MD, PhD

  3. Orthopädie am Rosenberg, Rorschacherstrasse 150, St. Gallen, 9006, Switzerland

    Matthias Jacobi MD

  4. Department of Orthopedic Surgery, Fayoum University, Fayoum, Egypt

    Ahmed Elguindy MD

  5. Department of Orthopaedic Surgery, Hôpital de la Croix-Rousse, Centre Albert Trillat, 103 Grande rue de la Croix-Rousse, Lyon, 69004, France

    Philippe Neyret MD

Authors
  1. Robert A. Magnussen MD
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  2. Sebastien Lustig MD, PhD
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  3. Matthias Jacobi MD
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  4. Ahmed Elguindy MD
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  5. Philippe Neyret MD
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Corresponding author

Correspondence to Robert A. Magnussen MD .

Editor information

Editors and Affiliations

  1. Orthopaedic Surgery, Hospital for Special Surgery Weill Cornell Medical College, New York, New York, USA

    Robert G. Marx

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Magnussen, R.A., Lustig, S., Jacobi, M., Elguindy, A., Neyret, P. (2014). The Role of Lateral Extra-articular Augmentation in Revision ACL Reconstruction. In: Marx, R. (eds) Revision ACL Reconstruction. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0766-9_15

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  • DOI: https://doi.org/10.1007/978-1-4614-0766-9_15

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-0765-2

  • Online ISBN: 978-1-4614-0766-9

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