Anterior Cruciate Ligament Augmentation for Rotational Instability Following Primary Reconstruction With an Accelerated Physical Therapy Protocol


The purpose of the present study is to present the results of anterior cruciate ligament (ACL) augmentation for patients having rotational instability despite an intact vertical graft in lieu of conventional revision ACL reconstruction. ACL augmentation surgery with a horizontal graft was performed to augment a healed vertical graft on five patients and an accelerated rehabilitation protocol was instituted. Functional outcomes were assessed by the Lower Extremity Functional Scale (LEFS) and the Modified Cincinnati Rating System (MCRS). All patients completed physical therapy within 5 months and were able to return to full military duty without limitation. LEFS and MCRS were significantly improved. ACL augmentation with a horizontal graft provides an excellent alternative to ACL revision reconstruction for patients with an intact vertical graft, allowing an earlier return to duty for military service members. (Journal of Surgical Orthopaedic Advances 22(1):59–65, 2013)

Timothy Carey, DO; David Oliver, MD; Josh Pniewski, DPT; Terry Mueller, DO; and
John Bojescul, MD