2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress ePoster

 

Long Term Outcome of Simultaneous Bilateral ACL Reconstruction

Justin P. Roe, MB BS BSc(Med) Hons, A/Prof., Lindfield, NSW AUSTRALIA
Raymond Kim, BMed MS (Ortho), Sydney, NSW AUSTRALIA
Lucy J. Salmon, PhD, Sydney, NSW AUSTRALIA
Leo A. Pinczewski, MBBS, FRACS, FAOA, Sydney, NSW AUSTRALIA

North Sydney Orthopaedic and Sports Medicine Centre, Sydney, NSW, AUSTRALIA

FDA Status Cleared

Summary

Simultaneous bilateral ACL reconstruction is associated with high rates of patient satisfaction and return to sport, and low rates of repeat ACL injury over the long term, and may considered an appropriate treatment in the setting of bilateral ACL deficiency.

ePosters will be available shortly before Congress

Abstract

Aims:
The purpose of this study is to document the long-term outcome of simultaneous bilateral anterior cruciate ligament reconstruction (ACLR) with respect to patient satisfaction, rate of return to sport and prevalence of further knee injuries.

Methods

Between 1993 and 2023 the senior authors performed simultaneous bilateral ACLR in 119 patients (238 knees). During the same period a total of 13,754 primary ACLR were performed, including 1416 staged bilateral ACLR. Simultaneous bilateral ACLR represent 1.7% of the total primary ACLR performed. In 2024 simultaneous bilateral ACLR patients were invited to complete patient reported outcomes via an online survey. The outcome assessed included patient reported satisfaction, rate of return to sport, activity level and rate of further knee injuries after simultaneous bilateral ACL reconstruction.

Results

Of the 119 eligible patients, 2 were deceased and 84 (168 knees) were reviewed at mean of 19 years (range 2 to 31) after bilateral ACLR. The primary ACL injuries occurred on 2 separate occasions in 76 patients (90%). In 8 patients (10%) the ACL injuries occurred on the same day, most commonly during skiing (n=6). At 19 years after surgery, 97% of patients were satisfied or very satisfied with the outcome of their surgery and 91% would have the same surgery again. A return to their preinjury activity at some point after their surgery was reported by 71%. ACL graft failure occurred 7% of knees, at a mean of 75 months (range 6-146 months). The 2-, 5- and 10-year survival of the ACL Graft was 98%, 96% and 95% for the left knee, and 99%, 97%, and 93% for the right knee.

Conclusion

Simultaneous bilateral ACL reconstruction is associated with high rates of patient satisfaction and return to sport, and low rates of repeat ACL injury over the long term, and may considered an appropriate treatment in the setting of bilateral ACL deficiency.