REVISION OF FAILED PROSTHETIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Revision of failed prosthetic anterior cruciate ligament reconstructio ns will continue to be necessary as previously placed prosthetic devic es fail with time, These patients often present with recurrent instabi lity, pain, swelling, or effusions. Graft rupture and the generation o f particulate debris are common causes of these symptoms, To effective ly treat these patients requires careful preoperative evaluation and p lanning. Operative treatment includes removing the prosthesis and meta l fixation devices, evaluating femoral and tibial bone stock, and dete rmining adequacy of previous tunnel position, Staging of the operation may be a necessity if significant bone loss or poor tunnel position o n either the femoral or tibial side requires bone grafting, The use of an autogenous bone-patellar tendon-bone graft is suggested and has pr oven to be effective in restoring knee stability in these revision cas es, The ultimate outcome following revision of failed prosthetic ligam ents may be limited by associated intraarticular pathology often seen in this patient population.