Artelon Graft Augmentation in Revision Anterior Cruciate Ligament Reconstruction: A Case Report

Introduction Anterior cruciate ligament (ACL) injuries are becoming more common in the United States. These commonly present following a non-contact twisting injury to the knee with an associated swelling of the joint. ACL injuries are commonly treated with reconstruction rather than repair to reduce time away from activities or respective sports. Studies have shown that revision ACL reconstructions not only result in less optimal outcomes but still carry a risk of failure. Graft selection with or without augmentation in ACL reconstruction is a debated topic. Artelon is a biologic option that can be used as a scaffold in revision ACL reconstruction. This report describes two similar patients who underwent a successful revision ACL reconstruction utilizing Artelon as a bio-scaffold. Methods Here we present two unique patient cases utilizing Artelon as a bio-scaffold to a tibialis anterior tendon (TAT) allograft in a revision ACL reconstruction. One surgeon performed this technique on each patient. Both patients were relatively healthy and similar in age with successful outcomes at 24 months postoperatively. Conclusion With graft failure in primary ACL reconstruction on the rise, revision ACL reconstruction has now become a more studied topic. Therefore, studies aimed at graft augmentation in revision cases, as described in this case report, have become a point of focus in the literature. In our study, we sewed the Artelon graft between the folded Tibialis Anterior tendon allograft to help resist rotational forces. There is a paucity of literature regarding outcomes of synthetic augmentation in the setting of primary and revision ACL reconstruction. Theoretically, synthetic augmentation would aid in avoidance of donor site morbidity, as well as avoid complications with insufficient graft diameter, length, and strength. In our case report, both patients demonstrated successful results at 24 months postoperatively, without evidence of complications. We hope this case report adds to the current literature regarding revision ACL graft options.