IC: 101

Title: IC 101: Which ACL Recon­struc­tion Needs More? A Case-Based Dis­cus­sion of Slope Cor­rec­tion, Lat­er­al Aug­men­ta­tion, Menis­cal Transplantation 

Course Description: 

Despite significant advances in anatomic ACL reconstruction, failure in at-risk patients continues to be a challenge for treating surgeons.  An improved understanding of modifiable risk factors, including tibial slope, coronal malalignment, hyperlaxity, condylar geometry, and meniscal deficiency, have all be recognized as potentially contributory to recurrent failure despite anatomic ACL reconstruction.  In 2021, however, the indications for slope and/or alignment correction or augmentation procedures (i.e., anterolateral ligament, iliotibial band based lateral augmentation, etc.) remain difficult to definitively define for treating surgeons.  Using a case-based approach, this ICL will use a case-based approach to presents these concepts and the considerations for graft selection, slope and alignment correction, and augmentation for primary ACL reconstruction.  Use of these procedures must be balanced with the potential morbidity of additional surgery and over constraint of the knee. 

Learning Objectives:

• Define the modifiable and nonmodifiable risk factors that predispose patients with ACL injury to a higher risk of failure after reconstruction.
• Review the indications for osteotomy for correction of increased tibial slope and/or coronal malalignment, and the indications for anterolateral ligament (ALL) or lateral extra-articular augmentation procedures (LEAP) for primary ACL reconstruction.         
• Review the technical approach for ALL and LEAP procedures, slope correcting osteotomy with concomitant ACL reconstruction.       
• Provide an evidence-based update of short and mid-term outcomes in the literature for primary ACL reconstruction and outcomes after slope corrective osteotomy and/or augmentation procedures.

Faculty

Asheesh Bedi, MD

Jorge Chahla, MD, PhD

Alan M. Getgood, MD, FRCS (Tr&Orth)

Christopher M. Larson, MD

Bryson P. Lesniak

Volker Musahl, MD

Alexander E. Weber, MD.