Summary

ACL revision surgery allows an adequate return to sport in most patients, but it requires a change in the type of sports activity and the level at which it is performed, negatively affecting clinical scores.

Abstract

Introduction

Return to sports is one of the key indicators of a successful outcome for patients undergoing anterior cruciate ligament (ACL) reconstruction.
Although the results of revision ACL reconstruction are generally considered to be inferior to those of primary ACL reconstruction, there is no consensus regarding the rates of return to sport in these patients.

Objective

Evaluate the rate of return to sports, the type of sport and its frequency after ACL revision surgery in a cohort of patients operated at the same center.

Methods

Retrospective cohort study. A database of all patients with revision surgeries from 2009 to 2020 was extracted. 124 patients with ACL revision surgery by the same surgical team were included.
A survey was conducted by telephone and email evaluating the type of sports activity and frequency before and after primary surgery and revision surgery.
In the statistical analysis, Student's t-test was used for significance of 5% (p<0.05).

Results

The average age of the patients surveyed was 27.67 years (SD 9.05).
84.6% of the patients were male (105/124).
97,6% of patients performed sports prior to the primary injury, and 45 of them (36.9%) performed more than 1 sport.
The most practiced sport prior the primary injury was soccer (70.2%), followed by jogging (13.7%) and tennis (12.1%).
After the revision surgery, the number of patients who practiced soccer significantly diminished, persisting in the first place (17.74%) and the practice of jogging (15.32%) and tennis (14.52%) increased.
15 patients stopped playing sports (12.09%) after revision surgery.
The average time for return to sports was 9.55 months (2-48 months).
The average score on the Cincinnati scale prior to primary surgery was 89.91 points. After revision surgery, the score dropped significantly to an average of 80.65 points (p=0.0001).
The average Tegner score before primary surgery was 6.63 points. After revision surgery, a statistically significant decrease was demonstrated with an average of 5.3 points (p=0.0001).

Conclusion

ACL revision surgery allows an adequate return to sport in most patients. However, it requires a change in the type of sports activity and the level at which it is performed, negatively affecting all clinical scores evaluated.