Revision Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Allograft and Extra-Articular Iliotibial Band Tenodesis
Revision anterior cruciate ligament (ACL) reconstruction is a technically demanding procedure with outcomes that generally fail to reach those seen with primary ACL reconstruction. With most index procedures using autograft tissue, it is not uncommon for allograft tissue to be required for revision ACL reconstruction. Compared with autografts, allografts take longer to incorporate and lead to more episodes of instability.
In this article, we describe ipsilateral iliotibial band tenodesis performed to augment use of bone–patellar tendon–bone allograft in revision ACL reconstruction. This technique adds rotational stability to protect the allograft tissue while it incorporates.
Conclusion
This technique allows for protection of the intra-articular allograft ligament reconstruction with improved rotational control that may potentially allow for improved subjective outcomes and protect against graft failure. Given the common pitfalls with stability in revision ACL surgery with allograft, this lateral extra-articular procedure can be an important structural augmentation in this challenging clinical issue in knee surgery.
