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One-stage anterior cruciate ligament revision surgery after primary failed double-bundle reconstruction: a systematic review

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Anterior cruciate ligament (ACL) revision surgery after failed double-bundle (DB) reconstruction is a challenging procedure. This study aimed to systematically review the research on ACL revision surgery following failed DB reconstruction, providing an overview on indications, surgical techniques, clinical outcomes and potential pitfalls occurring while performing this therapeutic approach.

Materials and Methods

Literature published from exception to February 2023 was searched in the Pubmed/MEDLINE, Embase and CINAHL databases. Studies in English reporting on patients who underwent ACL revision surgery after prior failed DB reconstruction were considered. Review articles and expert opinion or editorial pieces were excluded. Outcomes of interest included indications and pre-operative planning, surgical technique and associated procedures, type of revision surgery (either one- or two-stage), graft choice, clinical and functional outcomes, rate of complications, failure rate.

Results

Overall, 4 studies met all the inclusion criteria for this review. All were published between 2007 and 2020. The search resulted in two retrospective comparative studies, one case series, and one case report. Average follow-up periods ranged from 24 to 45 months. From these studies, 66 patients (66 knees) were identified. One-stage revision surgery was performed in 64 on 66 patients (97%) with pathologic laxity following DB ACL reconstruction. Most frequently reported outcome was Lysholm score in five studies: average postoperative Lysholm score ranged from 90.5 to 91.0 while Tegner activity level ranged from 5.6 to 7.0. In 4 patients (6%) re-revision surgery was performed due to graft re-rupture.

Conclusions

One-stage ACL revision surgery following DB ACL reconstruction appears feasible providing satisfying outcomes and limited complications. The literature on this subject is limited and further comparative studies reporting long-term outcomes are needed, as high-level studies on this topic are still lacking.

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Authors and Affiliations

  1. IRCCS Istituto Ortopedico Galeazzi, Sports Traumatology and Minimally Invasive Articular Surgery Center, Milan, Italy

    Claudio Legnani, Enrico Borgo, Vittorio Macchi & Alberto Ventura

  2. Sports Medicine and Arthroscopic Center Hospital Mehiläinen, Tampere, Finland

    Timo Järvelä

Authors
  1. Claudio Legnani
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  2. Timo Järvelä
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  3. Enrico Borgo
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  4. Vittorio Macchi
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  5. Alberto Ventura
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Correspondence to Claudio Legnani.

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Legnani, C., Järvelä, T., Borgo, E. et al. One-stage anterior cruciate ligament revision surgery after primary failed double-bundle reconstruction: a systematic review. Arch Orthop Trauma Surg 143, 7115–7121 (2023). https://doi.org/10.1007/s00402-023-05022-6

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  • DOI: https://doi.org/10.1007/s00402-023-05022-6

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