Single-Stage Revision Anterior Cruciate Ligament Reconstruction Using the Stacked Screws Technique

Ian D Engler; Stephen M Sylvia; Matthew J Salzler; Julianne M Forlizzi; Thomas J Gill 4th

doi:10.1016/j.eats.2022.03.020

Single-Stage Revision Anterior Cruciate Ligament Reconstruction Using the Stacked Screws Technique

Arthrosc Tech. 2022 Jun 21;11(7):e1341-e1345. doi: 10.1016/j.eats.2022.03.020. eCollection 2022 Jul.

Authors

Ian D Engler^{1

2}, Stephen M Sylvia², Matthew J Salzler², Julianne M Forlizzi³, Thomas J Gill 4th^{4

5}

Affiliations

¹ UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
² Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts.
³ Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, Massachusetts.
⁴ Professor of Orthopaedic Surgery, Tufts University School of Medicine, Boston, Massachusetts.
⁵ Steward Healthcare System, Boston Sports Medicine, Dedham, Massachusetts, U.S.A.

Abstract

Single-stage revision anterior cruciate ligament (ACL) reconstruction is preferable to 2-stage revision, when possible, as it avoids an additional surgery and recovery period. Malpositioned and/or widened bone tunnels are a common cause of ACL reconstruction failure and are challenging to manage in revision reconstructions. The "stacked screws construct" fills the previous malpositioned tunnels and bone voids with an oversized biocomposite screw as graft material. The revised tunnel can then be drilled in an anatomic "primary" location, even partially overlapping the filler screw. This technique simplifies tunnel management in revision ACL reconstruction.