Kew Michelle E, Miller Mark D, Werner Brian C
Department of Orthopaedics, University of Virginia, Charlottesville, VA.
Sports Med Arthrosc Rev. 2020 Jun;28(2):e11-e17. doi: 10.1097/JSA.0000000000000262.
Anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure, with an increasing frequency leading to an increased number of revision procedures. Etiologies for graft rupture are varied and can include technical issues, repeat trauma, and graft choice. The preoperative evaluation before a revision ACL reconstruction should include a detailed history and physical exam, as well as radiographs, magnetic resonance imaging to evaluate graft integrity and for concomitant injuries, as well as computed tomography to measure for bone tunnel osteolysis. Surgical techniques for revision ACL reconstruction include a 1-stage or 2-stage procedure with possible bone grafting and repair of associated injuries. Recent studies show worse clinical outcomes after a revision procedure; however, research continues to emerge with novel techniques and rehabilitation protocols to improve patient outcomes after revision ACL reconstruction.
前交叉韧带（ACL）重建是一种常见的手术，随着其实施频率的增加，翻修手术的数量也在增多。移植物破裂的病因多种多样，可能包括技术问题、反复创伤和移植物选择。翻修ACL重建术前评估应包括详细的病史和体格检查，以及X线片、用于评估移植物完整性和并发损伤的磁共振成像，还有用于测量骨隧道骨质溶解的计算机断层扫描。翻修ACL重建的手术技术包括一期或二期手术，可能需要植骨并修复相关损伤。最近的研究表明翻修手术后的临床结果较差；然而，随着新技术和康复方案的不断涌现，旨在改善翻修ACL重建术后患者预后的研究仍在继续。
