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J Knee Surg 2012; 25(05): 361-368
DOI: 10.1055/s-0031-1299662
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Femoral Tunnel Malposition in ACL Revision Reconstruction

Joseph A. Morgan
1   Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Diane Dahm
1   Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Bruce Levy
1   Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Michael J. Stuart
1   Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota
,
and the MARS Study Group › Institutsangaben
Weitere Informationen

Publikationsverlauf

10. Mai 2011

21. August 2011

Publikationsdatum:
03. Mai 2012 (online)

    Lizenzen und Reprints

Abstract

The Multicenter Anterior Cruciate Ligament (ACL) Revision Study (MARS) group was formed to study a large cohort of revision ACL reconstruction patients. The purpose of this subset analysis study of the MARS database is to describe specific details of femoral tunnel malposition and subsequent management strategies that surgeons chose in the revision setting. The design of this study is a case series. The multicenter MARS database is compiled from a questionnaire regarding 460 ACL reconstruction revision cases returned by 87 surgeons. This subset analysis described technical aspects and operative findings in specifically those cases in which femoral tunnel malposition was cited as the cause of primary ACL reconstruction failure. Of the 460 revisions included for study, 276 (60%) cases cited a specific “technical cause of failure.” Femoral tunnel malposition was cited in 219 (47.6%) of 460 cases. Femoral tunnel malposition was cited as the only cause of failure in 117 cases (25.4%). Surgeons judged the femoral tunnel too vertical in 42 cases (35.9%), too anterior in 35 cases (29.9%), and too vertical and anterior in 31 cases (26.5%). Revision reconstruction involved the drilling of an entirely new femoral tunnel in 91 cases (82.1%). For primary reconstruction, autograft tissue was used in 82 cases (70.1%). For revision reconstruction, autograft tissue was used in 61 cases (52.1%) and allograft tissue in 56 cases (47.9%). Femoral tunnel malposition in primary ACL reconstruction was the most commonly cited reason for graft failure in this cohort. Graft selection is widely variable among surgeons.

Keywords

anterior cruciate ligament - reconstruction - revision - technique

* The list of MARS Study Group collaborators can be found at the end of the article.


 

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