Management of Bone Loss and Tunnel Widening in Revision ACL Reconstruction.

McMellen, Christopher J; Sinkler, Margaret A; Calcei, Jacob G; Hobson, Taylor E; Karns, Michael R; Voos, James E · J Bone Joint Surg Am · 2023

review · Level V

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Abstract

➤ Both mechanical and biological factors can contribute to bone loss and tunnel widening following primary anterior cruciate ligament (ACL) reconstruction.➤ Revision ACL surgery success is dependent on graft position, fixation, and biological incorporation.➤ Both 1-stage and 2-stage revision ACL reconstructions can be successful in correctly indicated patients.➤ Potential future solutions may involve the incorporation of biological agents to enhance revision ACL surgery, including the use of bone marrow aspirate concentrate, platelet-rich plasma, and bone morphogenetic protein-2.

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