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Revision Anterior Cruciate Ligament Reconstruction in the Setting of Underlying Connective Tissue Laxity

This case appears in the HSS publication Grand Rounds from HSS - Management of Complex Cases, Winter 2015 - Volume 5, Issue 3, Case 1

Case 1, presented by Scott A. Rodeo, MD and Brook R. Crowe, BA illustrates challenges in revision ligament reconstruction in a patient with underlying connective tissue laxity. It describes a 51-year-old female with a past medical history of mixed connective tissue disorder consistent with lupus and rheumatoid arthritis who presented with right knee instability after having undergone ACL reconstruction in 2009 using semitendonosis/gracilis tendon autograft. Examination revealed anterior cruciate ligament insufficiency in the setting of generalized ligamentous laxity, with both varus and valgus laxity and patellar hypermobility. Recurrent knee instability persisted despite a comprehensive strengthening program so it was elected to proceed with a two-stage revision ligament reconstruction. At early 4-month follow-up, the patient is well satisfied with excellent stability and progressive function.

Read full case details in Volume 5, Issue 3 of Grand Rounds - Complex Cases.

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For any questions or comments regarding GRMCC, email complexcases@hss.edu.