Outcomes of a Single-stage Only Approach to Every Revision Anterior Cruciate Ligament Reconstruction

Description

This presentation, led by Adnan Saithna alongside co-author Bertrand Sonnery-Cottet, critically evaluates the outcomes of a single-stage approach to revision Anterior Cruciate Ligament (ACL) reconstruction, challenging the conventional reliance on a two-stage strategy due to low supporting evidence. The study focused on patients with preoperative tunnel widening, often prompting consideration for a two-stage reconstruction. Emphasizing the effectiveness of the outside-in drilling technique, which allows a flexible and anatomically unconstrained access for drilling new tunnels, the presentation outlines the methodology of correcting previous tunnels using this technique, thus ensuring robust bone bridges between new and existing tunnels.



A cohort of 409 patients was analyzed, with a follow-up that included comprehensive assessments of patient-reported outcomes (PROMs), rehabilitation protocols, and reoperation rates. The findings revealed no significant differences in clinical outcomes between groups classified based on tunnel sizes, suggesting that a single-stage revision ACL reconstruction does not negatively impact graft success rates or knee stability, irrespective of tunnel widening. In conclusion, Saithna advocates for the single-stage method as a viable and effective option for revision ACL surgeries, welcoming further discussion and inquiries post-presentation.

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