Revision single stage anterior cruciate ligament reconstruction using 3anterolateral tibial tunnel

BackhroundsPurpose Revision Anterior Cruciate Ligament Reconstruction (ACL-R) is a technicallydemanding enterprise. Management of widened or previously malposition tunnels is achallenging issue and often requires innovative approaches. The purpose of this studywas to evaluate the function and clinical results of revision single stage ACL surgeryusing the anterolateral tibia tunnel.MethodsMethods 93 revision ACL reconstruction knees from 2012 to 2015 were involved inthis study. We focused on 25 knees with malposition or dilatation of the tibial tunnel.All these patients underwent revision single stage ACL reconstruction using theanterolateral tibial tunnel, with a minimum of 2 years follow-up. The clinical resultswere evaluated by means of the Lysholm score, IKDC score and Tegner activity levelscale, and the knee stability was assessed by the Lachman test, pivot shift test, andanterior drawer test. MRI of the index knee before the surgery and two years afterrevision surgery was assessedResultsPatients were followed-up for a minimum of 2 years (range 51 - 24 months). The meanpreoperative IKDC subjective score improved from 6.92 ± 60.45 preoperatively to 72.29 4.71 ± at last follow-up (P < 0.001). The mean Tegner activity level scale improved from1.89 ± 5.09 to 1.25 ± 7.69 (P< 0.01), and the mean Lysholm score improved from ± 63.48.23 to 6.41 ± 80.86 (P< 0.015) preoperatively and at last follow-up respectively.ConclusionsCreation of the lateral tibial tunnel is an applicable solution in ACL revision surgerywhen the surgeon is not able to perform an optimal medial tibial tunnel because of thepartially misplaced tunnel or altered bone stock encountered in the medial side. Oneshould expect acceptable tunnel length, intact and fresh bony surrounding, perfectgraft fixation and comparable stability in ACL revision surgeries using the anterolateraltibial tunnel in comparison to the standard anteromedial tibial tunnel