IC 102-2024: Optimizing ACL Reconstruction in 2024: A Case-Based Approach-IC102

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Video Summary

The discussion at the AOSSM conference covered a range of topics centered on optimizing outcomes following ACL reconstruction. Dr. Mary Mulcahy moderated the session, introducing notable faculty members like Dr. Cassandra Lee, who stressed that BTP (bone-tendon-bone) remains the gold standard for ACL reconstruction, citing pros such as high load to failure and fast graft incorporation. Dr. Lee emphasized the importance of understanding patient-specific factors including sports involvement and knee laxity when choosing grafts.<br /><br />Dr. Mulcahy herself advocated for quad autograft as a reliable and reproducible option, citing its advantages like a robust graft size and minimal donor site morbidity. She illustrated her points through a case study involving a young soccer player, detailing the surgical approach, including graft preparation and fixation.<br /><br />Dr. Simon Gertz discussed challenges faced by Dr. Clay Nolley due to flight issues and briefly touched on augmentation options for ACL reconstruction, highlighting the utility and considerations of procedures like LET (lateral extra-articular tenodesis). Dr. Adnan Saithna shared a complex case of a 35-year-old female athlete undergoing a re-revision ACL surgery, underlining the importance of comprehensive evaluation and the two-stage revision process.<br /><br />Dr. Bertrand Ver from Norway contributed insights on transitioning to using quad autografts and discussed the importance of LAT in reducing graft rupture rates. He also disapproved of using suture augmentation due to potential complications like synovitis.<br /><br />In terms of practical approaches, the panel discussed using tourniquets, TXA (tranexamic acid), and the reliability of different graft fixations and techniques. The session concluded with a consensus on the importance of adopting comprehensive and patient-specific approaches to ACL reconstruction, leveraging different graft options and augmented procedures to optimize patient outcomes.

Keywords

AOSSM conference

ACL reconstruction

Dr. Mary Mulcahy

BTP graft

quad autograft

patient-specific factors

graft preparation

LET procedure

Dr. Adnan Saithna

two-stage revision

LAT technique

TXA use