Revision of failed anterior cruciate ligament reconstruction with quadrupled semitendinosus allograft: intermediate-term outcome

Chougule, Sanjay; Tselentakis, George; Stefan, Stefania; Stefanakis, Georgeos

doi:10.1007/s00590-014-1549-2

Cited by 10 publications

(5 citation statements)

References 27 publications

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“…At a mean follow‐up of 5 years (range 2–13 years), the re‐rupture rate was reported to be broad, from 0 to 25%. Among the included studies, only three used allografts exclusively for ACL revision, reporting a re‐rupture rate between 0 and 5% and mid‐term [2, 20, 27].…”

Section: Discussionmentioning

confidence: 99%

Double-bundle non-anatomic ACL revision reconstruction with allograft resulted in a low revision rate at 10 years

Macchiarola

Pizza

Patania

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeThis study aimed at reporting the long‐term second revision rate and subjective clinical outcomes from a cohort of patients who underwent a double‐bundle (DB) ACLR first revision with allograft at a single institution. MethodsThe Institutional database was searched according to the following inclusion criteria: (1) patients that underwent DB‐ACL first revision with Achilles tendon allograft, (2) surgery performed between January 2000 and December 2012, (3) age at revision ≥ 18 y/o. Patients’ general information, history, surgical data, and personal contacts were extracted from charts. An online survey platform was implemented to collect responses via email. The survey questions included: date of surgeries, surgical data, date of graft failure and subsequent second ACL revision surgery, any other surgery of the index knee, contralateral ACLR, KOOS score, and Tegner scores. ResultsEighty‐one patients were included in the survival analysis, mean age at revision 32 ± 9.2 y/o, 71 males, mean BMI 24.7 ± 2.7, mean time from ACL to revision 6.8 ± 5.4 years, mean follow‐up time 10.7 ± 1.4 years. There were 12 (15%) second ACL revisions during the follow‐up period, three females and nine males, at a mean of 4.5 ± 3 years after the index surgery. The overall survival rates were 85% from a second ACL revision and 68% from all reoperations of the index knee. Considering only the successful procedures (61 patients), at final follow‐up, the mean values for the KOOS subscales were 84 ± 15.5 for Pain, 88.1 ± 13.6 for Symptoms, 93 ± 11.6 for ADL, 75 ± 24.5 for Sport, and 71 ± 19.6 for Qol. Twenty‐nine (48%) patients performed sports activity at the same level as before ACLR failure. ConclusionsDouble‐bundle ACL revision with fresh‐frozen Achilles allograft yields satisfactory results at long‐term follow‐up, with an 85% survival rate from a second ACL revision at mean 10 years’ follow‐up and good patient‐reported clinical scores. Level of evidenceLevel IV.

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Section: Discussionmentioning

confidence: 99%

Double-bundle non-anatomic ACL revision reconstruction with allograft resulted in a low revision rate at 10 years

Macchiarola

Pizza

Patania

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…12,[31][32][33] In retrospective studies, the mean Lysholm's score for those with revision ACL reconstruction ranged from 58 to 92. 12,19,24,26,27,30,[34][35][36][37][38][39] Two of these studies had control groups for comparison of Lysholm's scores between revision ACLR and primary ACLR cohorts. 36,38 Denti et al found that Lysholm's scores were 57% excellent (95-100 points), 13% good (84-94 points), 22% fair (63-83 points), and 8% poor (<64 points) in 66 patients with revision ACLR.…”

Section: Discussionmentioning

confidence: 99%

Revision Anterior Cruciate Ligament Reconstruction after Surgical Management of Multiligament Knee Injury

Worley

Brimmo

Nuelle³

et al. 2020

J Knee Surg

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The purpose of this study is to determine factors associated with the need for revision anterior cruciate ligament reconstruction (ACLR) after multiligament knee injury (MLKI) and to report outcomes for patients undergoing revision ACLR after MLKI. This involves a retrospective review of 231 MLKIs in 225 patients treated over a 12-year period, with institutional review board approval. Patients with two or more injured knee ligaments requiring surgical reconstruction, including the ACL, were included for analyses. Overall, 231 knees with MLKIs underwent ACLR, with 10% (n = 24) requiring revision ACLR. There were no significant differences in age, sex, tobacco use, diabetes, or body mass index between cohorts requiring or not requiring revision ACLR. However, patients requiring revision ACLR had significantly longer follow-up duration (55.1 vs. 37.4 months, p = 0.004), more ligament reconstructions/repairs (mean 3.0 vs. 1.7, p < 0.001), more nonligament surgeries (mean 2.2 vs. 0.7, p = 0.002), more total surgeries (mean 5.3 vs. 2.4, p < 0.001), and more graft reconstructions (mean 4.7 vs. 2.7, p < 0.001). Patients in both groups had similar return to work (p = 0.12) and activity (p = 0.91) levels at final follow-up. Patients who had revision ACLR took significantly longer to return to work at their highest level (18 vs. 12 months, p = 0.036), but similar time to return to their highest level of activity (p = 0.33). Range of motion (134 vs. 127 degrees, p = 0.14), pain severity (2.2 vs. 1.7, p = 0.24), and Lysholm's scores (86.3 vs. 90.0, p = 0.24) at final follow-up were similar between groups. Patients requiring revision ACLR in the setting of a MLKI had more overall concurrent surgeries and other ligament reconstructions, but had similar final outcome scores to those who did not require revision surgery. Revision ligament surgery can be associated with increased pain, stiffness, and decrease patient outcomes. Revision surgery is often necessary after multiligament knee reconstructions, but patients requiring ACLR in the setting of a MLKI have good overall outcomes, with patients requiring revision ACLR at a rate of 10%.

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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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Revision of failed anterior cruciate ligament reconstruction with quadrupled semitendinosus allograft: intermediate-term outcome

Abstract: Retrospective case series, Level IV.

Cited by 10 publications

References 27 publications

Double-bundle non-anatomic ACL revision reconstruction with allograft resulted in a low revision rate at 10 years

Double-bundle non-anatomic ACL revision reconstruction with allograft resulted in a low revision rate at 10 years

Revision Anterior Cruciate Ligament Reconstruction after Surgical Management of Multiligament Knee Injury

Revision Anterior Cruciate Ligament Reconstruction in Military Personnel

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