Two-Stage Revision Anterior Cruciate Ligament Reconstruction with Cannulated Allograft Bone Dowels Soaked in Bone Marrow Aspirate Concentrate
Anterior cruciate ligament reconstruction (ACLR) is one of the most common orthopedic procedures performed each year. The majority of patients undergoing these reconstructions will experience long-term stability and symptomatic relief; however, some will require a revision ACLR procedure. In general, revision ACLRs are more challenging than primary ACLRs due to several considerations. A revision ACLR can be performed in one surgery but may sometimes require two surgeries. The decision to perform an ACLR in two separate surgeries is based on the tunnel position from the previous surgery and degree of bone loss. Recently, the introduction of pre-shaped bone grafts from human donors has gained popularity as a graft option for revision ACLR procedures. They provide immediate structural stability and avoid some of the risks associated with bone grafts taken from your own body. The purpose of this article is to outline a bone-grafting tunnel technique with pre-shaped bone grafts from a human donor soaked in stem cells used in the first stage of a staged revision ACLR procedure.