Revision ACL Reconstruction

It is estimated that between 1.8% and 10.4% of patients who undergo an ACL reconstruction will require a revision.¹ Restoring a previously malpositioned ACL tunnel or widened tunnels can be challenging, sometimes requiring a two-stage approach.² The Cannulated Bone Dowel Kit offers surgeons a simplified solution to effectively address these issues. Allograft bone dowels act as a biologic scaffold to provide an immediate structural architecture and promote osseous integration. The bone dowels can be soaked in platelet-rich plasma (PRP) or bone marrow concentrate to provide autologous cells and growth factors that facilitate graft incorporation.

Additionally, press-fit nature and structural integrity of the bone dowels provides surgeons the option to take a single-stage approach in cases where no more than half of the failed tunnel is violated. Favorable outcomes have been reported for patients undergoing single-stage ACL reconstruction using allograft bone dowels.³

Along with allograft bone dowels, the FlipCutter® III drill is particularly advantageous in setting a revision ACL reconstruction. The all-in-one adjustable guide pin and reamer allows surgeons to precisely debride remnant tissue and maximize residual bone stock during tunnel preparation.

^References

^{1. MARS Group, Ding DY, Zhang AL, et al. Subsequent surgery after revision anterior cruciate ligament reconstruction: rates and risk factors from a multicenter cohort. Am J Sports Med. 2017;45(9):2068-2076. doi:10.1177/0363546517707207}

^{2. Richter DL, Werner BC, Miller MD. Surgical pearls in revision anterior cruciate ligament surgery. when must I stage? Clin Sports Med. 2017;36(1):173-187. doi:10.1016/j.csm.2016.08.008}

^{3. Werner BC, Gilmore CJ, Hamann JC, et al. Revision anterior cruciate ligament reconstruction: results of a single-stage approach using allograft dowel bone grafting for femoral defects. J Am Acad Orthop Surg. 2016;24(8):581-587. doi:10.5435/JAAOS-D-15-00572}

• Revising Two-Stage BioACL Technique
  • Arthrex - BioACL™ Technique
• Revising Two-Stage Quad Tendon Autograft
  • Arthrex - Quad Tendon Graft ACL Reconstruction
• Revising Two-Stage BTB Autograft
  • Arthrex - BTB Autograft ACL Reconstruction
• Revising Two-Stage HT Autograft
  • Arthrex - Hamstring Autograft ACL Reconstruction
• Revising Two-Stage Allograft
  • Arthrex - Allograft ACL Reconstruction
• Allograft Bone
  • Bone Grafting with Revision Bone Dowels Arthrex - Cannulated Revision Bone Dowels