Two-Stage Revision Anterior Cruciate Ligament Reconstruction with Cannulated Allograft Bone Dowels Soaked in Bone Marrow Aspirate Concentrate

Arthrosc Tech. 2021 Nov 16;10(12):e2699-e2708. doi: 10.1016/j.eats.2021.08.013. eCollection 2021 Dec.

Abstract

Anterior cruciate ligament reconstruction (ACLR) is one of the most common orthopedic procedures performed each year. The majority of patients undergoing these reconstructions will experience long-term stability and symptomatic relief; however, some will require a revision ACLR procedure. In general, revision ACLRs are more challenging than primary ACLRs due to several diagnostic and technical considerations. A revision ACLR can be performed with either a one-stage or two-stage procedure, which is based on the presence or absence of malpositioned tunnels, bone loss, and tunnel expansion. Recently, the introduction of preshaped allograft bone dowels as a bone grafting option has gained popularity. They provide immediate structural stability and avoid donor site morbidity associated with autografts. The purpose of this article is to outline a bone-grafting tunnel technique with cannulated allograft bone dowels soaked in bone marrow aspirate concentrate (BMAC) used in the first stage of a staged revision ACLR procedure.