Revision of anterior cruciate ligament reconstruction with allografts in patients younger than 40 years old: a 2 to 4 year results

Pascual‐Garrido, Cecilia; Carbó, Lisandro; Makino, Arturo

doi:10.1007/s00167-013-2507-y

Cited by 23 publications

(20 citation statements)

References 26 publications

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“…Literature reports very satisfactory results with patellar tendon allograft thanks to the bone plugs and its better adaptation into a large bone tunnel. 35 Especially in case of multiple failures and when peripheral reconstructions are needed, the use of allograft is strongly reccomended. 31,36 In our experience, we have used a prevalence of autograft BPTB and allograft as graft for the last revision surgery.…”

Section: Discussionmentioning

confidence: 99%

Multiple ACL Revision: Failure Analysis and Clinical Outcomes

et al. 2019

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Anterior cruciate ligament (ACL) reconstruction represents one of the most successful orthopedic surgical procedures. Nevertheless, ACL revisions are still very frequent, with a small but relevant number of failures. The purpose of this study is to analyze the failure causes and the clinical outcomes of patients who underwent a re-revision ACL reconstruction. Between January 2009 and December 2017, 263 ACL revisions were performed by a single senior surgeon. Seventeen patients (12 males and 5 females) underwent re-revision ACL reconstruction meeting the inclusion criteria. The mean age was 28.4 years (range, 19–41 years). Before the re-revision, the patients were evaluated preoperatively and after a mean follow-up of 29 months (range, 13–58 months). Assessment included subjective and objective evaluations (Lysholm and International Knee Documentation Committee [IKDC]), KT-2000 arthrometer, radiographic study, and preoperative computed tomography scan. Five patients showed a too anterior previous femoral tunnel and seven a too vertical and posterior tibial tunnel; eight meniscal tears were found. Five patients had grade III–IV according to Outerbridge cartilage lesions. IKDC showed a statistically significant improvement (A + B 35%, C + D 65% preop, A + B 82%, C + D 18% postop, odds ratio: 0.1169; p = 0.0083). The mean Lysholm score ranged from 43 ± 9 to 87 ± 7 (p < 0.001). The KT-2000 arthrometer showed a statistically significant improvement from a mean of 5.8 ± 1.4 to 1.5 ± 1.1 (p < 0.001) at last follow-up. Out of 17 patients, only 4 returned to sports activity at the same preinjury levels. Postoperatively at the last follow-up after last revision surgery, no osteoarthritis evolution was observed. This study showed good clinical and radiological results after the last revision ACL surgery in patients with multiple failures of ACL reconstruction but only one-fourth of the patients returned to the same preoperative sport level. Traumatic events, technical errors, and untreated peripheral lesions are the main causes of multiple previous failures; the worst clinical outcomes were found in the patients with high grade of chondral lesions.

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Section: Discussionmentioning

confidence: 99%

Multiple ACL Revision: Failure Analysis and Clinical Outcomes

et al. 2019

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“…Multiple studies have shown that revision ACL reconstruction has low-complication rates and good clinical results at both short-and midterm follow-up, with significant improvements in knee stability, patient-reported outcome scores, and patient satisfaction. 4,6,9,[23][24][25][26][27] Comparative studies, however, have consistently reported results that are inferior to primary ACL reconstruction. 5,7,8,12 Increased rates of meniscal and chondral pathology may contribute to this discrepancy.…”

Section: Discussionmentioning

confidence: 99%

Revision Anterior Cruciate Ligament Reconstruction in Military Personnel

et al. 2015

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This study aims to report the clinical and functional outcomes of revision anterior cruciate ligament (ACL) reconstruction in a young, active duty military population. Patients undergoing revision ACL reconstruction were enrolled in an institutional clinical database and followed prospectively. The primary outcomes were patients' scores on a timed run, as compared with recorded scores before reinjury. Secondary outcomes included scores on the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the International Knee Documentation Committee subjective (IKDC subjective), the Short Form - 36 health survey (SF-36) version 2, the Single Assessment Numeric Evaluation (SANE), and the Tegner activity scale. A total of 13 patients were identified who met the inclusion criteria and had complete follow-up. The mean age at revision ACL reconstruction was 20.5 years (range, 19-22 years), and mean follow-up was 40.2 months (range, 13-66 months). All patients underwent a single stage revision ACL reconstruction with ipsilateral bone-patellar tendon-bone autograft, ipsilateral hamstring autograft, or bone-tendon-bone allograft. Mean physical readiness test (PRT) score at final follow-up was not statistically different than documented preinjury PRT score (77.9 vs. 85.5, p > 0.05), nor was the mean run time (7:12 vs. 6:43/mile, p > 0.05). Significant improvements exceeding published minimal clinically important differences were seen in SANE score, SF-36 physical component summary score, KOOS sports and recreation, KOOS quality of life, WOMAC pain score, and WOMAC function score. Patients undergoing revision ACL reconstruction at our facility show good recovery of baseline physical performance as measured by the semiannual PRT and timed run test, and significant improvements in patient-reported outcome scores. Level of Evidence Level IV, case series.

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“…Full-text articles excluded (n = 10) Reverte-Vinaixa [69] x x x Mahmoud [53] x x x Shelbourne [74] x x x Pascual-Garrido [66] x x Ventura [87] x…”

Section: Eligibility Identificationmentioning

confidence: 99%