Tomohiro Tomihara1, Yusuke Hashimoto2, Masatoshi Taniuchi3, Junsei Takigami3, Changhun Han3, Nagakazu Shimada3. 1. Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, 583-0875, Japan. m2033754@med.osaka-cu.ac.jp. 2. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. 3. Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, 583-0875, Japan.
Abstract
PURPOSE: The purpose of this study is to assess the results of revision anterior cruciate ligament (ACL) reconstruction after the failure of primary ACL double bundle reconstruction (ACL-DBR). METHODS: Twenty-two knees in 22 patients (group R) that underwent ACL revision surgery using bone-patellar tendon-bone (BTB) autograft after the failure of primary ACL-DBR were included in this study. Intraoperative findings and postoperative knee laxity and clinical outcomes in group R were assessed. Forty-four knees in 44 patients that were age- and gender- matched with group R and underwent primary ACL reconstruction using BTB autograft were used as a control group (group P). RESULTS: The incidence of medial meniscus and cartilage injury in group R was significantly higher than those in group P (p < 0.05). At final follow-up, median Lysholm score was 90.5 (64-100) in group R and 94 (59-100) in group P, respectively. Fourteen patients (63.6%) in group R and 31 patients (70.5%) in group P were able to return to previously-played sports, respectively. There were no significant differences in KT-1000 outcomes (2.0 mm in group R and 1.4 mm in group P) or pivot shift test between the two groups. The rate of subsequent ACL injury was similar in both groups. CONCLUSIONS: Revision ACL reconstruction using BTB autograft after failed primary ACL-DBR provided almost compatible postoperative clinical outcomes and knee stability with primary ACL reconstruction using BTB autograft, while the incidence of medial meniscus and cartilage injury at revision surgery was higher. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.
PURPOSE: The purpose of this study is to assess the results of revision anterior cruciate ligament (ACL) reconstruction after the failure of primary ACL double bundle reconstruction (ACL-DBR). METHODS: Twenty-two knees in 22 patients (group R) that underwent ACL revision surgery using bone-patellar tendon-bone (BTB) autograft after the failure of primary ACL-DBR were included in this study. Intraoperative findings and postoperative knee laxity and clinical outcomes in group R were assessed. Forty-four knees in 44 patients that were age- and gender- matched with group R and underwent primary ACL reconstruction using BTB autograft were used as a control group (group P). RESULTS: The incidence of medial meniscus and cartilage injury in group R was significantly higher than those in group P (p < 0.05). At final follow-up, median Lysholm score was 90.5 (64-100) in group R and 94 (59-100) in group P, respectively. Fourteen patients (63.6%) in group R and 31 patients (70.5%) in group P were able to return to previously-played sports, respectively. There were no significant differences in KT-1000 outcomes (2.0 mm in group R and 1.4 mm in group P) or pivot shift test between the two groups. The rate of subsequent ACL injury was similar in both groups. CONCLUSIONS: Revision ACL reconstruction using BTB autograft after failed primary ACL-DBR provided almost compatible postoperative clinical outcomes and knee stability with primary ACL reconstruction using BTB autograft, while the incidence of medial meniscus and cartilage injury at revision surgery was higher. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.
Authors: Randy Mascarenhas; Michael J Tranovich; Eric J Kropf; Freddie H Fu; Christopher D Harner Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-11-03 Impact factor: 4.342