Outside-In Drilling Allows Avoidance of Two-Stage Surgery in Revision Anterior Cruciate Ligament Reconstruction

Haidar, Ibrahim; Billières, Julien; Saithna, Adnan; Rayes, Johnny; Fradin, Thomas; Ngbilo, Cédric; Vieira, Thaïs Dutra; Cavaignac, Étienne; Sonnery‐Cottet, Bertrand

doi:10.1016/j.eats.2020.10.057

Cited by 7 publications

(4 citation statements)

References 12 publications

(12 reference statements)

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“…Even in the case of a diameter larger than 15 mm, some techniques have been described to bypass the problem of a precarious fixation of the new graft in the former tunnel if a one-stage revision is required or suggested for clinical or personal reasons. Haidar et al ( 108 ) proposed the use of an out-in technique for femoral tunnel drilling. They stated that this technique makes for a different obliquity of the tunnel and thereby allows for a solid fixation and good integration of the graft even in the case of a previous femoral tunnel of greater diameter.…”

Section: One- or Two- Stage Surgerymentioning

confidence: 99%

Anterior cruciate ligament failure and management

2023

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Anterior cruciate ligament (ACL) reconstruction failure can be defined as abnormal knee function due to graft insufficiency with abnormal laxity or failure to recreate a functional knee according to the expected outcome. Traumatic ruptures have been reported as the most common reason for failure. They are followed by technical errors, missed concomitant knee injuries, and biological failures. An in-depth preoperative examination that includes a medical history, clinical examinations, advanced imaging, and other appropriate methods is of utmost importance. There is still no consensus as to the ideal graft, but autografts are the favorite choice even in ACL revision. Concomitant meniscal treatment, ligamentous reconstruction, and osteotomies can be performed in the same surgical session to remove anatomical or biomechanical risk factors for the failure. Patient expectations should be managed since outcomes after ACL revision are not as good as those following primary ACL reconstruction.

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Section: One- or Two- Stage Surgerymentioning

confidence: 99%

Anterior cruciate ligament failure and management

2023

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“…20 The existing tunnels require reorientation. The new femoral tunnel will be created by outside-in drilling to eliminate the risk of overlap 21 while an allograft bone plug (Biobank, Lieusaint, France) will be used to fill the overly anterior tibial tunnel and allow us to drill the correct tibial tunnel right away.…”

Section: Surgical Techniquementioning

confidence: 99%

“…During one-stage surgery, outside-in drilling of the femoral tunnel prevents overlap with the existing tunnel, even if the femoral tunnel is semianatomic. 13 , 20 , 21 Conversely, when the tibial tunnel is semianatomic, it is difficult to make a new tunnel in the correct position without overlapping the existing tunnel. For this reason, we have developed a one-stage revision surgery that uses a bone allograft plug.…”

Section: Introductionmentioning

confidence: 99%

One-Stage ACL Revision Using a Bone Allograft Plug for a Semianatomic Tibial Tunnel That Is Too Anterior

Philippe

Marot

Courtot

et al. 2022

Arthroscopy Techniques

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“…Outside-in drilling avoids the need for 2-stage RACLR because it allows unconstrained anatomic placement. 3,4 Conversely, transtibial or anteromedial portal techniques are limited and therefore more likely to require 2-stage RACLR. Additionally, the rates of ACLR combined with a lateral extra-articular procedure (LEAP) have increased as a result of the increasing body of literature on the anterolateral ligament (ALL) and its role in rotational control of the knee.…”

mentioning

confidence: 99%