Optimizing Anterior Cruciate Ligament (ACL) Outcomes: What Else Needs Fixing Besides the ACL?

Optimizing Anterior Cruciate Ligament (ACL) Outcomes: What Else Needs Fixing Besides the ACL? Instr Course Lect. 2020;69:653-660 Authors: Spang RC, Getgood A, Strickland SM, Amendola AN, Gomoll AH Abstract This review focuses on the management of anterior cruciate ligament (ACL) reconstruction patients when other concomitant pathology may need to be addressed at the time of surgery. Given the role of the posterior horn of the medial meniscus in preventing osteoarthritis progression and contributing to knee stability, medial meniscus repair should always be considered when performing ACL reconstruction. Meniscal transplant may also be appropriate in select patients with normal knee alignment and absent of cartilage abnormalities in the compartment. Varus alignment with a varus thrust or increased posterior tibial slope will increase stress on the ACL graft and may predispose to early failure. Alignment should be assessed with appropriate radiographs and corrective osteotomy in isolation or in conjunction with ACL reconstruction should be considered for certain patients. Low-grade medial collateral ligament (MCL) and lateral collateral ligament (LCL) injuries can be treated nonsurgically prior to ACL reconstruction. These are frequently missed with either physical examination or radiographic imaging. High-grade LCL injuries are often treated with repair versus reconstruction in conjunction with ACL reconstruction depending on the timin...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research