Single Stage Novel Method of Treating Anterior Cruciate Ligament Failure, Revision and Reconstruction using Bone-Patellar Tendon-Bone Graft with Suture Disc and Lateral Extra-Articular Tenodesis: A Retrospective Study

Objectives: Anterior cruciate ligament (ACL) reconstruction surgery has become popular with the advent of recent surgical techniques.With increasing sporting activities and active lifestyles, the need to travel makes the population “prone to ACL and multiligament injuries in the knee ”. As the number of ACL reconstruction surgeries rises, there is also a surge ACL failures due to re-injuries or various other reasons. The aim of this study is to evaluate the clinical outcomes, efficacy, and biomechanical stability of a single-stage novel method for treating ACL failure through revision ACL reconstruction using a bone-patellar tendon-bone (BTB) graft with suture disc and lateral extra-articular tenodesis (LET). Material and Methods: The use of a BTB graft for ACL failure surgery makes it more biological, and the suture disc ensures that the bone does not get crushed with the interference screw. Lateral extra-articular tenodesis reduces rotational stress on the knee and helps secure a stronger reconstruction of the ACL. Results: All of our patients recovered completely; there was no incidence of post-op infection, and the activity level reached normal within 8-10 weeks. The mean Lysholm score significantly improved from 25.4 ± 4.4 preoperatively to 87.1 ± 4.6 at 6months (p < 0.0001), indicating substantial functional recovery. Sporting activities were allowed after 6 months of reconstruction. Conclusion: In a single-stage revision, an ACL reconstruction with BTB graft and extra-articular tenodesis proved superior and produced much more secure and stronger results. The time taken to return to sports is also reduced significantly.