Patients Undergoing Second Revision ACL Reconstruction Present Higher Rates of Associated Osteotomies, Complications and Failure Compared to Patients Undergoing First Revision ACL Reconstruction


Andre Giardino Moreira Da Silva, MD
BRAZIL

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Patients Undergoing Second Revision ACL Reconstruction Present Higher Rates of Associated Osteotomies, Complications and Failure Compared to Patients Undergoing First Revision ACL Reconstruction

Camilo P. Helito, MD, PhD, Prof, BRAZIL Andre Giardino Moreira Da Silva, MD, BRAZIL Riccardo Cristiani, MD, PhD, SWEDEN Anders Stalman, MD, PhD, Associate Professor, SWEDEN Vitor Barion Castro De Padua, PhD, BRAZIL Riccardo Gomes Gobbi, MD, PhD, BRAZIL José R. Pécora, Prof., BRAZIL

University of São Paulo, São Paulo, SP, BRAZIL

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Sports Medicine

Orthopaedic Sports Medicine Sport Specific Injuries

Diagnosis / Condition

Instability

Treatment / Technique

Repair / Reconstruction

Patient Populations

Sport Specific Population

Anatomic Location

Knee

Anatomic Structure

Ligaments

Diagnosis Method

Physical Examination MRI

Ligaments

ACL Anterolateral Ligament

Summary: Patients who underwent second revision ACL reconstruction presented higher rates of associated osteotomies, complications and failure compared to patients who underwent first revision ACL reconstruction. Lysholm and IKDC scores, KT-1000 measurements and pivot-shift test did not present clinically relevant differences between groups.

Background

Few comparative studies have evaluated patients who underwent two revision anterior cruciate ligament reconstruction (ACLR) and patients who underwent one revision ACLR, and many of them have a short postoperative follow-up and a relatively small number of patients. The objective of this study is to evaluate the functional results, complications, and failure rates of patients who underwent one revision ACLR and patients who underwent two revision ACLRs.

Methods

This is a retrospective study comparing patients who underwent one revision ACLR (Group 1) with patients who underwent a two revision ACLR (Group 2). Baseline demographic variables, operative data and post-operative data were evaluated.

Results

Among the 266 patients included, 226 were from Group 1 and 40 from Group 2. Patients in Group 2 had greater rotatory laxity and were more often subjected to associated osteotomy at the time of revision surgery. Postoperatively, patients from Group 2 reported poorer subjective IKDC score and showed greater knee laxity measured with the KT-1000 arthrometer, although both probably not clinically relevant. The complication rate was high in both groups, with a higher incidence in Group 2. Reconstruction failures were also higher in Group 2 (20% vs. 8.8%, p = 0.03).

Conclusion

Patients from Group 2 underwent a higher rate of associated osteotomy procedures, present higher complication rates and a higher failure rate compared with patients from Group 1. However, the functional scores (Lysholm and IKDC score) and the physical examination (KT-1000 and pivot-shift) did not show clinically relevant differences between the groups.

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