2025 ISAKOS Biennial Congress ePoster
Outcomes Of Revision ACL Reconstruction In Professional Football Players: A Retrospective Analysis Of Graft Types, And Postoperative Results
Saseendar Shanmugasundaram, MBBS, MS, DNB, MNAMS, Dip SICOT,, Pondicherry, Puducherry INDIA
Samundeeswari Saseendar, MBBS, MS Ortho, MBA HHSM, Puducherry, Puducherry INDIA
Sri Lakshmi Narayana Institute of Medical Sciences, Pondicherry, Pondicherry, INDIA
FDA Status Cleared
Summary
This study evaluates the outcomes of revision ACL reconstruction in professional football players, demonstrating good functional results with careful preoperative planning and emphasizing the critical role of addressing alignment pathologies and ligament laxity to achieve optimal postoperative outcomes.
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Abstract
Background
Advancements in arthroscopic surgeries have significantly increased the incidence of ACL reconstruction worldwide, but re-tear rates remain high at 20-25%. This study examines the outcomes of revision ACL reconstruction surgeries using various graft types and techniques.
Methods
We retrospectively reviewed outcomes of revision ACL reconstructions performed over the past 4 years at our institute. The study included 32 professional football players with a mean age of 29 years (range: 24–45 years), who underwent revision ACL reconstruction with bone-patella tendon-bone (BPTB) or quadriceps tendon grafts, with or without suture tape augmentation. Clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and ligament laxity assessments, with follow-up lasting a minimum of 24 months.
Results
The duration between index surgery and failure ranged from 12 to 150 months. Revision surgeries were performed with various fixation methods, including hybrid and high-noon fixation. Tunnel position errors were noted, with femoral tunnel positioning being less ideal compared to tibial positioning. Posterior tibial slope was significantly higher in patients with contact failures. The mean KOOS score improved from 71.3 to 91.5. Associated injuries included meniscus damage (32/32), grade 4 chondral injury (30/32), and a higher incidence of alignment issues (4/32). Graft types used for revision included BPTB (56.25%), hamstring (31.25%), and quadriceps (12.5%). Of the patients, 65.6% returned to sports, primarily recreational (85.7%), with 34.4% not returning. Functional outcomes showed good Lysholm scores in 9.3% of patients, fair in 81.25%, and poor in 9.3%. Failure causes included repeat injury (68.75%) and no repeat injury (31.25%).
Conclusion
Revision ACL reconstruction can yield favorable functional outcomes, particularly when preoperative planning addresses alignment and tunnel position issues. Structured rehabilitation and careful surgical technique are crucial for optimal results, with attention needed for associated injuries and alignment pathologies.