Arthroscopic Delivery of Injectable Bone Graft for Staged Revision Anterior Cruciate Ligament Reconstruction

Bone defects caused by femoral and tibial tunnel enlargement can pose a significant technical challenge when planning to perform revision anterior cruciate ligament reconstruction. A number of options have been described for managing osseous deficiencies, including the use of large autograft or allograft bone dowels to provide sufficient tunnel fill and subsequent structural support for revision surgery. These techniques can be time-consuming and technically demanding to ensure proper tunnel fill and press-fit stability of the bone graft. We describe our preferred technique for arthroscopic bone grafting using a mixture of demineralized cortical bone graft augmented with platelet-rich plasma delivered through a simple delivery system.