The association of extra-articular tenodesis restores rotational stability more effectively compared to contralateral hamstring tendon autografts ACL reconstruction alone in patients undergoing ACL revision surgery

2020 ◽  
Author(s):  
Alberto Ventura ◽  
Claudio Legnani ◽  
Francesca Boisio ◽  
Enrico Borgo ◽  
Giuseppe M. Peretti
Keyword(s):  
Acl Reconstruction ◽  
Revision Surgery ◽  
Hamstring Tendon ◽  
Rotational Stability ◽  
Acl Revision ◽  
Acl Revision Surgery

scholarly journals RISK FACTORS FOR FAILURE FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN A PEDIATRIC POPULATION: A NOVEL PREDICTION ALGORITHM

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Nicholas J. Lemme ◽  
Daniel S. Yang ◽  
Brooke Barrow ◽  
Ryan O’Donnell ◽  
Alan Daniels ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Revision Surgery ◽  
Pediatric Patients ◽  
Cruciate Ligament ◽  
Acl Revision ◽  
Risk Algorithm ◽  
Anterior Cruciate ◽  
Acl Revision Surgery

Background: Pediatric anterior cruciate ligament (ACL) reconstruction is becoming increasingly common, however, there is limited literature on the risk factors for failure in this demographic. Hypothesis/Purpose: In the present study we sought to: 1. To determine the rate of pediatric ACL reconstruction (ACLR) failure requiring revision surgery in a nationally representative sample. 2. To determine the associated patient/injury-specific risk factors for ACLR failure. 3. To examine the differences in the rate and risks of failure between pediatric and adult patients. Methods: Patient records were drawn from Humana individual health plans and Medicare medical records. Adult and pediatric patients who underwent primary ACLR and subsequent reoperation for either ACL revision surgery or a revision meniscal procedure between 2011-2016 were identified. Multivariate regression was used to determine the significant risk factors for ACL revision and overall reoperation rates in pediatric and adult patients. A risk algorithm was developed to predict the risk of ACL revision following pediatric ACL reconstruction. Results: Pediatric patients were significantly more likely to require ACL revision within one year (OR=1.97, 95%CI 1.57-2.45, p<0.0001) and five years (OR=3.22, 95%CI 2.77-3.72, p<0.0001) following their index ACLR compared to adults. Survivorship of the index ACL procedure was significantly decreased in pediatric patients (log-rank test p<0.0001) (Figure 1). Pediatric patients were also at higher risk of sustaining a contralateral ACL tear compared to adults (5.9% vs. 1.4%, respectively, p<0.0001). Meniscus injury was a risk factor for overall re-operation (OR=2.18, 95%CI 1.67-2.89 p<0.0001) as well as ACL revision (OR=2.28, 95%CI=1.66-3.21, p<0.0001) in the pediatric cohort. This increased risk was sustained despite the type of meniscal tear intervention, with patients undergoing concurrent meniscal repair (OR=1.84, 95%CI 1.43-2.38, p<0.0001) or meniscectomy (OR=2.20, 95%CI 1.72-2.82, p<0.0001) having a higher likelihood of requiring a revision ACLR. Concomitant MCL injury but not LCL injury was a risk factor for ACL revision in this cohort (OR=1.70, 95%CI 1.31-2.19, p<0.0001). Male sex and (OR=0.78, 95%CI 0.63-0.96, p=0.0204) and being >14 years old (OR=0.62, 95%CI 0.45-0.86, p=0.0035) was associated with a decreased risk of overall reoperation. The risk algorithm demonstrated the highest probability for ACLR failure in females, less than 15 years of age, with concomitant meniscus and MCL injury, demonstrating a 36% risk of failure (Table 1). Conclusion: Compared to adults, pediatric patients have an increased likelihood of ACL revision surgery, contralateral ACL tears, and meniscal reoperation within 5 years of an index ACLR. [Table: see text][Figure: see text]

scholarly journals The role of anatomic ACL reconstruction in ACL revision surgery

2018 ◽  
Vol 3 ◽  
pp. 103-103
Author(s):  
Robert Tisherman ◽  
Joseph De Groot ◽  
Benjamin Rothrauff ◽  
Kevin Byrne ◽  
Sean J. Meredith ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Revision Surgery ◽  
Anatomic Acl Reconstruction ◽  
Acl Revision ◽  
Acl Revision Surgery

The course of the patellar tendon after reharvesting its central third for ACL revision surgery: a long-term clinical and radiographic study

2006 ◽  
Vol 14 (11) ◽  
pp. 1130-1138 ◽  
Author(s):  
Mattias Lidén ◽  
Lars Ejerhed ◽  
Ninni Sernert ◽  
Åke Bovaller ◽  
Jon Karlsson ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Revision Surgery ◽  
Radiographic Study ◽  
Acl Revision ◽  
Acl Revision Surgery

Revision Single-Stage Anterior Cruciate Ligament Reconstruction Using an Anterolateral Tibial Tunnel

2019 ◽  
Vol 33 (04) ◽  
pp. 410-416
Author(s):  
Sohrab Keyhani ◽  
Behzad Hanafizadeh ◽  
René Verdonk ◽  
Mohammadreza Minator Sajjadi ◽  
Mehran Soleymanha
Keyword(s):  
Revision Surgery ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Clinical Results ◽  
Activity Level ◽  
Acl Revision ◽  
Anterior Cruciate ◽  
Level Scale ◽  
Tegner Activity Level ◽  
Acl Revision Surgery

AbstractRevision anterior cruciate ligament (ACL) reconstruction is a technically demanding enterprise. Management of widened or previously malpositioned tunnels is challenging and often requires innovative approaches. The purpose of this study was to evaluate the function and clinical results of revision single-stage ACL surgery using an anterolateral tibial tunnel (ALTT). A consecutive series of knees with arthroscopic ACL revision surgery were analyzed prospectively between April 2012 and September 2015. Among the 93 patients presented with revision ACL reconstruction, 25 patients met the study inclusion criteria for the ALTT technique and were followed up for a minimum of 2 years (range: 24–51 months). The clinical results were evaluated by means of the Lysholm score, International Knee Documentation Committee (IKDC) score, and Tegner activity level scale, and the knee stability was assessed by the Lachman test, pivot shift test, and anterior drawer test. Magnetic resonance imaging (MRI) of the index knee before the surgery and 2 years after revision surgery was assessed. The mean IKDC subjective score, mean Tegner activity level scale, and mean Lysholm score significantly improved in all study participants. This study showed that ACL revision surgery with ALTT can reliably restore stability and provide fair functional outcomes in patients with ACL retear. One could expect acceptable lateral tibial tunnel length compared with medial tibial tunnel in classic ACL revision, intact bony surround, and good graft fixation. This technique is clinically relevant in that making an anterolateral tunnel in one-stage ACL revision surgery had a good subjective result with low complication rate in midterm follow-up.

scholarly journals Adolescents Have Twice the Revision Rate of Young Adults After ACL Reconstruction With Hamstring Tendon Autograft: A Study From the Swedish National Knee Ligament Registry

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110388
Author(s):  
Baldur Thorolfsson ◽  
Eleonor Svantesson ◽  
Thorkell Snaebjornsson ◽  
Mikael Sansone ◽  
Jon Karlsson ◽  
...  
Keyword(s):  
Young Adults ◽  
Acl Reconstruction ◽  
Pediatric Patients ◽  
Revision Rate ◽  
Hamstring Tendon ◽  
Age Group ◽  
Knee Ligament ◽  
Acl Revision ◽  
Hamstring Tendon Autograft ◽  
Tendon Autograft

Background: Previous studies have identified young age as a risk factor for anterior cruciate ligament (ACL) revision. However, few studies have looked separately at pediatric patients and adolescents with regard to outcomes after ACL reconstruction. Purpose: To determine whether patient age at ACL reconstruction affects the risk of undergoing revision surgery in young patients. Study Design: Cohort study; Level of evidence, 3. Methods: This study was based on data from the Swedish National Knee Ligament Registry. Patients aged 5 to 35 years who underwent a primary ACL reconstruction with a hamstring tendon autograft between January 1, 2005, and December 31, 2015, were included. The cohort was stratified into different age groups of pediatric patients, adolescents, and young adults to estimate patients with open, recently closed, and closed epiphyses, respectively. The primary endpoint was ACL revision. A multivariable Cox regression model was used to assess the ACL revision rate. The results were expressed as hazard ratios (HRs) and 95% CIs. Results: A total of 36,274 ACL reconstructions were registered during the study period. Of these, 2848 patients were included in the study: 47 pediatric patients (mean age, 13.6 years; range, 9-15 years), 522 adolescents (mean age, 17.4; range, 14-19 years), and 2279 young adults (mean age, 27.0; range, 20-35 years). A total of 31 patients (1.1%) underwent ACL revision within 2 years (0 pediatric patients, 9 adolescents [1.7%], and 22 young adults [1.0%]) and a total of 53 patients (2.6%) underwent ACL revision within 5 years (2 pediatric patients [6.9%], 15 adolescents [3.9%], and 36 young adults [2.2%]). The adolescent age group had a 1.91 times higher rate of ACL revision compared with the young adults (HR = 1.91 [95% CI, 1.13-3.21]; P = .015). There were no differences in revision rates between the pediatric age group and the young adults (HR = 2.93 [95% CI, 0.88-9.79]; P = .081). Conclusion: Adolescents had almost twice the rate of revision ACL reconstruction compared with young adults.

scholarly journals Outcomes after bone grafting in patients with and without ACL revision surgery: a retrospective study

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Theresa Diermeier ◽  
Elmar Herbst ◽  
Sepp Braun ◽  
Emine Saracuz ◽  
Andreas Voss ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Revision Surgery ◽  
Bone Grafting ◽  
Acl Revision ◽  
Acl Revision Surgery

scholarly journals Results of Anatomic Approach to ACL Revision Surgery (SS-71)

2012 ◽  
Vol 28 (6) ◽  
pp. e37-e38
Author(s):  
Paulo Araujo ◽  
Carola Francisca Van Eck ◽  
Jeffrey Macalena ◽  
Freddie H. Fu
Keyword(s):  
Revision Surgery ◽  
Acl Revision ◽  
Acl Revision Surgery
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