Instr Course Lect. 2023;72:461-476.
Several factors contribute to the greater complexity of revision anterior cruciate ligament reconstruction compared with primary anterior cruciate ligament reconstructive surgery. Prior tunnels and hardware may compromise revision tunnel placement and secure fixation. This may necessitate two-stage revision or specific techniques to achieve anatomic revision tunnels. Prior autograft use may limit graft options. Individuals with a failed anterior cruciate ligament reconstruction are more likely to have risk factors for further failure. These may include malalignment, occult instability, knee hyperextension, or increased tibial slope. There are also higher rates of meniscus and cartilage injuries in revision anterior cruciate ligament reconstruction that may require intervention. Successful revision anterior cruciate ligament reconstruction requires thoughtful preoperative planning along with multiple potential intraoperative plans depending on the pathology encountered. It is important to provide the orthopaedic surgeon with an up-to-date, evidence-based overview of how to approach and execute a successful revision anterior cruciate ligament reconstruction.
与初次前交叉韧带重建手术相比，翻修前交叉韧带重建手术更为复杂，这涉及多个因素。既往的隧道和内固定物可能会影响翻修隧道的定位和固定的稳定性。这可能需要两阶段翻修或特定的技术来实现解剖学上的翻修隧道。既往自体移植物的使用可能会限制移植物的选择。初次前交叉韧带重建失败的患者更有可能存在进一步失败的风险因素。这些因素可能包括对线不良、隐匿性不稳定、膝关节过伸或胫骨平台倾斜增加。翻修前交叉韧带重建中也有更高的半月板和软骨损伤发生率，可能需要干预。成功的翻修前交叉韧带重建需要术前进行深思熟虑的规划，以及根据遇到的病变制定多个潜在的术中计划。为骨科医生提供最新的、基于证据的方法概述，以了解如何进行和执行成功的翻修前交叉韧带重建非常重要。
