Alberto Grassi1, Nicola Pizza2, Luca Macchiarola1, Gian Andrea Lucidi1, Federico Stefanelli1, Giacomo Dal Fabbro1, Maurilio Marcacci3, Stefano Zaffagnini4. 1. II Clinica Ortopedica e Traumatologica, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy. 2. II Clinica Ortopedica e Traumatologica, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy. Electronic address: nicola.pizza@ior.it. 3. Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano, MI, Italy. 4. II Clinica Ortopedica e Traumatologica, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy; Dipartimento Scienze Biomediche e Neuromotorie-DIBINEM, Università di Bologna, Bologna, Italy.
Abstract
BACKGROUND: Anterior Cruciate Ligament (ACL) injuries have grown in adolescent population in the last decades, and if surgical reconstruction resulted safe in the short term, its impact in the long term is still unclear. The purpose of this study was to assess the long-term risk of failure, the rate of contralateral injury and the clinical reported outcomes in a cohort of high-school athletes after ACL reconstruction. METHODS: 54 consecutive patients (mean age 16.3 ± 1.4 years) underwent ACL reconstruction with a single-bundle plus lateral plasty hamstring technique between May 2006 and July 2009. The number of subsequent ipsilateral reoperations and contralateral ACL reconstruction, Lhysolm, KOOS, VAS for pain and Tegner Activity Level was determined at a minimum follow-up of 10 years. RESULTS: Ipsilateral ACL revision was performed in 8 (3.4%) patients, contralateral ACL reconstruction in 11 (21.1%). The average Lysholm score was 95.1 ± 9.2. The average KOOS was 96.5 ± 6.3 for the Pain subscale, 92.2 ± 9.0 for the Symptom subscale, 99.2 ± 1.8 for the ADL subscale, 94.1 ± 10.1 for the Sport subscale and 91.8 ± 14.5 for the Quality-of-life subscale. The average VAS for pain during activity was 1.7 ± 2.3. 90% returned to sport, 15% decreased the activity level, 61% of patients were still involved in sport, 35% at the same pre-injury level. CONCLUSION: At long-term, single-bundle hamstring ACL-R plus lateral-plasty in a cohort of high school athletes resulted to have a comparable graft failure rate and contralateral ACL injury with other surgical techniques.
BACKGROUND: Anterior Cruciate Ligament (ACL) injuries have grown in adolescent population in the last decades, and if surgical reconstruction resulted safe in the short term, its impact in the long term is still unclear. The purpose of this study was to assess the long-term risk of failure, the rate of contralateral injury and the clinical reported outcomes in a cohort of high-school athletes after ACL reconstruction. METHODS: 54 consecutive patients (mean age 16.3 ± 1.4 years) underwent ACL reconstruction with a single-bundle plus lateral plasty hamstring technique between May 2006 and July 2009. The number of subsequent ipsilateral reoperations and contralateral ACL reconstruction, Lhysolm, KOOS, VAS for pain and Tegner Activity Level was determined at a minimum follow-up of 10 years. RESULTS: Ipsilateral ACL revision was performed in 8 (3.4%) patients, contralateral ACL reconstruction in 11 (21.1%). The average Lysholm score was 95.1 ± 9.2. The average KOOS was 96.5 ± 6.3 for the Pain subscale, 92.2 ± 9.0 for the Symptom subscale, 99.2 ± 1.8 for the ADL subscale, 94.1 ± 10.1 for the Sport subscale and 91.8 ± 14.5 for the Quality-of-life subscale. The average VAS for pain during activity was 1.7 ± 2.3. 90% returned to sport, 15% decreased the activity level, 61% of patients were still involved in sport, 35% at the same pre-injury level. CONCLUSION: At long-term, single-bundle hamstring ACL-R plus lateral-plasty in a cohort of high school athletes resulted to have a comparable graft failure rate and contralateral ACL injury with other surgical techniques.