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Revision surgery after failed ACL reconstruction with artificial ligaments: clinical, histologic and radiographic evaluation

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Synthetic ligament for anterior cruciate ligament (ACL) reconstruction has been widely used in the past. Long-term follow-up has demonstrated the unreliability of many of these devices in ACL surgery, and problems may arise for the surgeon approaching a patient with failed artificial ligament reconstruction. The aim of this study is to investigate whether revision surgery may improve clinical and radiographic outcomes in patients with failed synthetic ACL reconstruction. Fourteen patients who were treated in the past with ACL reconstruction with synthetic grafts underwent two-stage revision surgery. Follow-up averaged 4.2 years (range 2–6 years). Mean KOOS score was 75.8 (SD 10.2); IKDC score was B in two patients, C in nine and D in three. The improvement compared to preoperative status was not statistically significant (p > 0.05). Four patients were positive to Lachman and anterior drawer tests. Mean side-to-side anterior laxity averaged 4.3 mm (SD 1.2). Biopsy specimens documented the presence of foreign body granulomatous reaction, giant foreign body cells and polyethylene wear particles. The level of osteoarthritis worsened at follow-up compared to preoperative status (p < 0.05). ACL revision surgery with autografts in patients who underwent previous failed primary synthetic ligament reconstruction does not improve clinical outcomes and does not influence the natural history of knee osteoarthritis started from artificial ligament debris.

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Conflict of interest

Each author discloses any financial and personal relationships (e.g., employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, grants or other funding) that might pose a conflict of interest in connection with the submitted article.

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Authors and Affiliations

  1. U.O.S.D. Chirurgia Articolare Mininvasiva (Minimally-Invasive Articular Surgery Unit), Istituto Ortopedico G. Pini, Milan, Italy

    Alberto Ventura, Clara Terzaghi & Enrico Borgo

  2. Scuola di Specializzazione in Ortopedia e Traumatologia, Università degli Studi di Milano, Milan, Italy

    Claudio Legnani

  3. Istituto Ortopedico G. Pini, Università degli Studi di Milano, Milan, Italy

    Walter Albisetti

Authors
  1. Alberto Ventura
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  2. Claudio Legnani
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  3. Clara Terzaghi
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  4. Enrico Borgo
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  5. Walter Albisetti
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Correspondence to Claudio Legnani.

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Ventura, A., Legnani, C., Terzaghi, C. et al. Revision surgery after failed ACL reconstruction with artificial ligaments: clinical, histologic and radiographic evaluation. Eur J Orthop Surg Traumatol 24, 93–98 (2014). https://doi.org/10.1007/s00590-012-1136-3

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  • DOI: https://doi.org/10.1007/s00590-012-1136-3

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