Revision surgery for failed anterior cruciate ligament reconstruction with extension deficiency

Chang, Moon Jong; Jeong, Jin Hwa; Chang, Chong Bum; Kim, Young Jun; Seo, Bo Kyung; Song, Min Kyu; Kang, Taehoon; Kang, Sungchul

doi:10.1111/sms.13274

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…When the cause of the deficit in mobility can be resolved at the same time as that of instability, the functional results have proven to be satisfactory. It is mostly true in the case of completely incorrect positioning of the tunnels or displaced meniscal or osteochondral tissues within the tibio-femoral joint ( 103 ).…”

Section: One- or Two- Stage Surgerymentioning

confidence: 99%

Anterior cruciate ligament failure and management

2023

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Anterior cruciate ligament (ACL) reconstruction failure can be defined as abnormal knee function due to graft insufficiency with abnormal laxity or failure to recreate a functional knee according to the expected outcome. Traumatic ruptures have been reported as the most common reason for failure. They are followed by technical errors, missed concomitant knee injuries, and biological failures. An in-depth preoperative examination that includes a medical history, clinical examinations, advanced imaging, and other appropriate methods is of utmost importance. There is still no consensus as to the ideal graft, but autografts are the favorite choice even in ACL revision. Concomitant meniscal treatment, ligamentous reconstruction, and osteotomies can be performed in the same surgical session to remove anatomical or biomechanical risk factors for the failure. Patient expectations should be managed since outcomes after ACL revision are not as good as those following primary ACL reconstruction.

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Section: One- or Two- Stage Surgerymentioning

confidence: 99%

Anterior cruciate ligament failure and management

2023

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“…It has been found, for instance, that after ACL reconstruction, 82% of the patients returned to sport participation; however, only 63% returned to their preinjury sport level [6,7]. Amongst young patients who return to their pre-trauma sports activity, the prevalence of a re-rupture of their ACL may be as high as 30% [8,9]. Additionally, reports show that around 7% of patients need revision ACL surgery and around 3.4% of patients have ACL reconstructions on the contralateral side [10].…”

Section: Introductionmentioning

confidence: 99%

Differences in Knee Shape between ACL Injured and Non-Injured: A Matched Case-Control Study of 168 Patients

Kuijk

Eggerding

Reijman

et al. 2021

JCM

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Objective: Anterior cruciate ligament (ACL) injury prevention programs could be more effective if we could select patients at risk for sustaining an ACL rupture. The purpose of this study is to identify radiographic shape variants of the knee between patients with and patients without an ACL rupture. Methods: We compared the lateral and Rosenberg view X-rays of 168 prospectively followed patients with a ruptured ACL to a control group with intact ACLs, matched for gender, after knee trauma. We used statistical shape modeling software to examine knee shape and find differences in shape variants between both groups. Results: In the Rosenberg view X-rays, we found five shape variants to be significantly different between patients with an ACL rupture and patients with an intact ACL but with knee trauma. Overall, patients who had ruptured their ACL had smaller, flatter intercondylar notches, a lower lateral tibia plateau, a lower medial spike of the eminence, and a smaller tibial eminence compared to control patients. Conclusion: Patients with an ACL rupture have smaller intercondylar notches and smaller tibial eminences in comparison to patients with an intact ACL after knee trauma.

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Outcome After Anterior Cruciate Ligament Revision

Horváth

Senorski

Westin

et al. 2019

Curr Rev Musculoskelet Med

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Purpose of Review To describe the current literature related to anterior cruciate ligament (ACL) revision in terms of surgical aspects, graft choices, concomitant injuries, patient-reported outcome, return to sport, and objective measurement outcome. Recent Findings An ACL rupture is a common knee injury, and the number of primary ACL reconstructions is increasing, implying a subsequent increase of ACL revisions in the future. It is widely accepted that an ACL revision is surgically challenging with a myriad of graft options to choose from. In many cases, simultaneous injuries to the index limb including meniscal and chondral lesions, respectively, are observed in the setting of a secondary ACL injury. Furthermore, the general understanding is that an ACL revision results in inferior outcome compared with a primary ACL reconstruction. Summary Surgical treatment of an ACL revision can be performed as one-stage or two-stage procedure depending on, for example, the presence of limb malalignments, concomitant injuries, and tunnel widening. Nonirradiated allografts and autologous patella tendon, hamstring tendon, and quadriceps tendon are feasible options for ACL revision. Concomitant injuries to the affected knee such as intraarticular chondral lesions are more common in the setting of an ACL revision compared with primary ACL reconstruction while a lower presence of concomitant meniscal pathology is reported at ACL revision. Patients undergoing ACL revision have lower clinical and patient-reported outcome and lower rates of return to sport when compared with primary ACL surgery cases. However, long-term follow-ups with large study cohorts evaluating outcome of ACL revision are limited. Further research is needed to confirm the present findings of this review.

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Revision surgery for failed anterior cruciate ligament reconstruction with extension deficiency

Abstract: ED in patients with recurrent instability after primary ACL reconstruction could be treated with good clinical result by addressing the pathological conditions causing ED in addition to ACL re-reconstruction.

Cited by 5 publications

References 26 publications

Anterior cruciate ligament failure and management

Anterior cruciate ligament failure and management

Differences in Knee Shape between ACL Injured and Non-Injured: A Matched Case-Control Study of 168 Patients

Outcome After Anterior Cruciate Ligament Revision

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