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Re-revision anterior cruciate ligament reconstruction showed more laxity than revision anterior cruciate ligament reconstruction at a minimum 2-year follow-up

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to compare patient demographics, associated lesions (concurrent meniscal and chondral injuries), and clinical outcomes between revision and re-revision anterior cruciate ligament reconstructions.

Methods

Patients who underwent revision or re-revision anterior cruciate ligament reconstruction between 2008 and 2016 with a minimum 2-year follow-up were retrospectively evaluated. Detailed patient demographic data, radiographic preoperative tunnel diameters, posterior tibia slope, and concurrent meniscal and chondral lesion were reviewed. Clinical scores and laxity tests’ results were compared between the groups at the last follow-up.

Results

Eighty-two patients (mean age, 33.8 ± 9.9 years; revision group, n = 62; re-revision group, n = 20) were included. The re-revision group showed a higher grade for preoperative arthritis (P < 0.001); more severe preoperative bone defects of the femoral (13.8 ± 2.6 vs 11.7 ± 2.7 mm, P = 0.004) and tibial tunnels (14.6 ± 2.4 vs 13.0 ± 2.3 mm, P = 0.010); and a higher prevalence of subtotal medial meniscectomy (P = 0.008) and chondral defects of the medial (P = 0.006) and lateral femoral condyles (P < 0.001), patella (P = 0.040), and trochlea (P = 0.036). At the final follow-up, the clinical scores did not differ significantly between the groups. However, the re-revision group showed more instability in the anterior drawer (P = 0.001), Lachman (P < 0.001), and pivot-shift (P < 0.001) tests, while a side-to-side difference was observed on the Telos stress radiographs (7.1 ± 4.7 vs 4.9 ± 3.7 mm, P = 0.038).

Conclusion

These findings showed that the patients who underwent re-revision had poor prognostic factors as compared with those who underwent revision anterior cruciate ligament reconstruction. Although the clinical scores did not differ significantly between the groups, the re-revision group showed more laxity at the 2-year follow-up.

Level of evidence

Cohort study; IV.

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Funding

This study received no funding.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kyung Hee University Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea

    Kyoung Ho Yoon, Jae Ho Kim, Yoo Beom Kwon & Eung Ju Kim

  2. Department of Orthopedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeongki-do, Republic of Korea

    Sang-Gyun Kim

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  1. Kyoung Ho Yoon
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  2. Jae Ho Kim
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Correspondence to Sang-Gyun Kim.

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The authors declare that they have no conflict of interest related to this study.

Ethical approval

This study was approved by the institutional review board. (ID: KHUH 2018-10-048, Kyung Hee University Hospital).

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Yoon, K.H., Kim, J.H., Kwon, Y.B. et al. Re-revision anterior cruciate ligament reconstruction showed more laxity than revision anterior cruciate ligament reconstruction at a minimum 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 28, 1909–1918 (2020). https://doi.org/10.1007/s00167-019-05653-6

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  • DOI: https://doi.org/10.1007/s00167-019-05653-6

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