scholarly journals Two-stage procedure in anterior cruciate ligament revision surgery: a five-year follow-up prospective study

2013 ◽  
Vol 37 (7) ◽  
pp. 1369-1374 ◽  
Author(s):  
Francesco Franceschi ◽  
Rocco Papalia ◽  
Angelo Del Buono ◽  
Biagio Zampogna ◽  
Lorenzo Diaz Balzani ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Prospective Study ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Two Stage ◽  
Anterior Cruciate

scholarly journals Risk Factors for Revision Anterior Cruciate Ligament Reconstruction and Frequency With Which Patients Change Surgeons

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711988048 ◽  
Author(s):  
Kirsty Sutherland ◽  
Mark Clatworthy ◽  
Kevin Chang ◽  
Richard Rahardja ◽  
Simon W. Young
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Significant Proportion ◽  
Primary Procedure ◽  
Subsequent Revision ◽  
Low Volume ◽  
Anterior Cruciate

Background: Revision surgery is a known complication after anterior cruciate ligament (ACL) reconstruction (ACLR), but the proportion of patients who seek a different surgeon for their revision procedure is unknown. Purpose: To determine the rate and risk factors for revision ACLR in New Zealand and to find the proportion of patients undergoing revision ACLR who see a different surgeon compared with their primary procedure as well as the factors that may influence this decision. Study Design: Case series; Level of evidence, 4. Methods: Data from New Zealand’s single government insurer, the Accident Compensation Corporation (ACC), were analyzed. All primary ACLR procedures performed between January 1, 2009, and December 31, 2014 were evaluated, and revision ACLR procedures performed between January 1, 2009, and December 31, 2016, were evaluated to allow for a minimum 2-year follow-up period. Cases undergoing subsequent revision were divided into those with the same or a different surgeon compared with the primary procedure. Risk factors for revision and change of surgeons were assessed, including age, sex, time from injury to surgery, time between primary and revision procedures, surgeon volume, and ethnicity. Results: A total of 15,212 primary ACLR procedures were recorded in 14,926 patients. The mean patient age was 29.2 years, and 61% were male patients. There were 676 subsequent revision procedures and 510 contralateral procedures during the study period, resulting in a 5-year survival rate of 95.5% for the ACL graft and 96.5% for the contralateral ACL. Risk factors for revision surgery included male sex, age <20 years, and <1 year from injury to surgery. Of the revision procedures, 44.5% (n = 301) were performed by a different surgeon compared with primary ACLR. For primary ACLR procedures performed by low-volume surgeons, 75.0% of patients requiring revision ACLR changed surgeons, compared with 21.5% for high-volume surgeons (≤10 vs >50 primary ACLR/y; hazard ratio, 10.70 [95% CI, 6.01-19.05]; P < .001). Other factors associated with change of surgeons included older age, longer time between primary and revision surgery, and Asian and Maori ethnicities. Conclusion: A significant proportion of patients change surgeons when requiring revision ACLR. In the absence of formal follow-up systems such as registries, surgeons, particularly those with a low volume of ACLRs, may underestimate their personal revision rate.

Revision Anterior Cruciate Ligament Reconstruction after Surgical Management of Multiligament Knee Injury

2020 ◽  
Author(s):  
John R. Worley ◽  
Olubusola Brimmo ◽  
Clayton W. Nuelle ◽  
Bradford P. Zitsch ◽  
Emily V. Leary ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Revision Surgery ◽  
Knee Injury ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Cruciate Ligament Reconstruction ◽  
Multiligament Knee Injury ◽  
Anterior Cruciate

AbstractThe purpose of this study is to determine factors associated with the need for revision anterior cruciate ligament reconstruction (ACLR) after multiligament knee injury (MLKI) and to report outcomes for patients undergoing revision ACLR after MLKI. This involves a retrospective review of 231 MLKIs in 225 patients treated over a 12-year period, with institutional review board approval. Patients with two or more injured knee ligaments requiring surgical reconstruction, including the ACL, were included for analyses. Overall, 231 knees with MLKIs underwent ACLR, with 10% (n = 24) requiring revision ACLR. There were no significant differences in age, sex, tobacco use, diabetes, or body mass index between cohorts requiring or not requiring revision ACLR. However, patients requiring revision ACLR had significantly longer follow-up duration (55.1 vs. 37.4 months, p = 0.004), more ligament reconstructions/repairs (mean 3.0 vs. 1.7, p < 0.001), more nonligament surgeries (mean 2.2 vs. 0.7, p = 0.002), more total surgeries (mean 5.3 vs. 2.4, p < 0.001), and more graft reconstructions (mean 4.7 vs. 2.7, p < 0.001). Patients in both groups had similar return to work (p = 0.12) and activity (p = 0.91) levels at final follow-up. Patients who had revision ACLR took significantly longer to return to work at their highest level (18 vs. 12 months, p = 0.036), but similar time to return to their highest level of activity (p = 0.33). Range of motion (134 vs. 127 degrees, p = 0.14), pain severity (2.2 vs. 1.7, p = 0.24), and Lysholm's scores (86.3 vs. 90.0, p = 0.24) at final follow-up were similar between groups. Patients requiring revision ACLR in the setting of a MLKI had more overall concurrent surgeries and other ligament reconstructions, but had similar final outcome scores to those who did not require revision surgery. Revision ligament surgery can be associated with increased pain, stiffness, and decrease patient outcomes. Revision surgery is often necessary after multiligament knee reconstructions, but patients requiring ACLR in the setting of a MLKI have good overall outcomes, with patients requiring revision ACLR at a rate of 10%.

scholarly journals Good to Excellent Functional Short-Term Outcome and Low Revision Rates Following Primary Anterior Cruciate Ligament Repair Using Suture Augmentation

2020 ◽  
Vol 9 (10) ◽  
pp. 3068
Author(s):  
Kristian Nikolaus Schneider ◽  
Benedikt Schliemann ◽  
Georg Gosheger ◽  
Christoph Theil ◽  
Jan Weller ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Functional Results ◽  
Acl Repair ◽  
Term Outcome ◽  
Ikdc Score ◽  
Anterior Cruciate

The aim of this study was to evaluate the functional outcome of primary anterior cruciate ligament (ACL) repair using suture augmentation (SA) in 93 consecutive patients (67 female) with a minimum follow-up of 12 months. Patients’ outcomes were determined using International Knee Documentation Committee (IKDC) score, Lysholm score (LS) and Tegner score (TS). Knee-laxity was assessed using the KT-1000 arthrometer. Eighty-eight patients (67 female, mean age 42 years ± standard deviation (SD) 13) were available for follow-up after a mean time of 21 months (range 12–39). Three patients (3%) underwent revision surgery and were excluded from functional analysis. The mean IKDC score was 87.4 ± 11, mean LS was 92.6 ± 11, mean pre-traumatic TS was 6 ± 2 and mean postoperative TS was 6 ± 2, with a mean difference (TSDiff) of 1 ± 1. The interval from injury to surgery had no significant impact on the postoperative IKDC (p = 0.228), LS (p = 0.377) and TSDiff (p = 0.572). Patients’ age (>40 years), BMI (>30) and coexisting ligament or meniscal injuries did not seem to influence postoperative functional results. Primary ACL repair using SA provides good to excellent functional outcomes with a low probability of revision surgery at a minimum of 12 months.

Risk Factors for Requiring a Revision Anterior Cruciate Ligament Reconstruction: A Case-Control Study

2019 ◽  
Author(s):  
Todd P. Pierce ◽  
Jennifer Kurowicki ◽  
John J. Kelly ◽  
Kimona Issa ◽  
Anthony Festa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Family History ◽  
Acl Reconstruction ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Revision Reconstruction ◽  
History Of ◽  
Anterior Cruciate

AbstractAnterior cruciate ligament (ACL) reconstruction is considered as a successful orthopaedic procedure that attempts to help patients return to their preinjury level of activity. However, some patients may need to undergo revision surgery, and this potentially may be associated with certain surgery-specific or patient risk factors. Therefore, the purpose of this study was to assess the potential role of (1) demographics, (2) family history, (3) graft choice, (4) sport, and (5) mechanism of injury (contact vs. noncontact) in the risk for needing a revision ACL for improved clinical outcomes. All patients who had undergone a primary ACL reconstruction between 2012 and 2016 were identified from at a single institution. About 312 patients who had a mean age of 24 years (range, 9–62 years) and a mean follow-up of 4 years (range, 1–10). Patients were further evaluated to identify those who had a revision. There were 19 patients (6.1%) with a mean age of 22 years (range, 13–38 years) and a mean follow-up of 5 years (range, 1–10) that required a revision reconstruction. Gender ratios (p = 0.56) and mean age (p = 0.44) were similar among the cohorts. Family history of ACL reconstruction had no association with revision risk (p = 0.57). Those with tibialis anterior allografts (37 vs. 4%; p = 0.0001) and hamstring allografts (16 vs. 1%; p = 0.0001) were far more likely to undergo a revision. Bone-tendon-bone (BTB) patella autografts were less likely (26 vs. 73%; p = 0.0001). Sport did not play a role in revision with those injured playing basketball (p = 0.61), football (p = 0.52), lacrosse (p = 0.52), soccer (p = 0.83), and volleyball (p = 0.61). There were a greater percentage of contact injuries that required revision (95 vs. 77%; p = 0.07). Graft selection played a significant role in requiring revision surgery with allografts portending to higher revision rates and BTB patella autografts conferring a lower risk.

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