Revision anterior cruciate ligament reconstruction with ipsi- or contralateral hamstring tendon grafts

Legnani, Claudio; Peretti, Giuseppe M.; Borgo, Enrico; Zini, Stefania; Ventura, Alberto

doi:10.1007/s00590-016-1894-4

Cited by 18 publications

(22 citation statements)

References 11 publications

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“…Their negative pivot-shift prevalence was lower compared with about 10% in previous reports. 24,29,57 In addition, the rerupture rate was 1.2% in their multicenter study. In our study, 90.5% in group C showed a negative pivot shift, while 53.5% in group I had a negative pivot shift (P \ .001).…”

Section: Discussionmentioning

confidence: 96%

Clinical Outcomes of Isolated Revision Anterior Cruciate Ligament Reconstruction or in Combination With Anatomic Anterolateral Ligament Reconstruction

et al. 2019

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Background: Although the cause of rotational instability after revision anterior cruciate ligament reconstruction (ACLR) is multifactorial, the rationale of adding an extra-articular procedure is based on its ability to restrict rotational instability. Purpose: To assess the effect of anterolateral ligament (ALL) reconstruction on revision ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 87 patients who underwent revision ACLR between March 2011 and July 2014 with a follow-up of more than 3 years were included in this retrospective study. Patients were divided into the isolated revision ACLR group (group I, n = 45, from March 2011 to January 2013) or the revision ACLR in combination with ALL reconstruction group (group C, n = 42, from February 2013 to July 2014). Subjective knee assessments including the subjective International Knee Documentation Committee (IKDC) form, Lysholm score, Tegner activity scale, and Anterior Cruciate Ligament–Return to Sport after Injury (ACL-RSI) scale were used. Clinical and functional tests were performed before surgery and at ≥6 months after surgery. All tests were usually completed at 36 months of follow-up. Results: The mean follow-up duration for groups I and C were 41.5 ± 8.2 and 38.2 ± 6.9 months, respectively ( P = .451). The subjective IKDC score, Tegner score, and ACL-RSI score were significantly better in group C compared with those in group I at the last follow-up (84.3 ± 18.5 vs 75.9 ± 19.2, 7.0 ± 0.8 vs 6.3 ± 0.7, and 69.5 ± 25.4 vs 51.9 ± 23.1, respectively), although they were not significantly different between the 2 groups at 12 months after surgery (79.2 ± 18.8 vs 76.7 ± 17.2, 6.7 ± 0.7 vs 6.5 ± 0.9, and 50.2 ± 24.6 vs 49.9 ± 25.1, respectively). There were no significant differences in KT-2000 arthrometer, isokinetic extensor strength, single-legged hop for distance, co-contraction test, or carioca test results between the 2 groups at the last follow-up ( P = .304, .068, .125, .056, and .066, respectively). Preoperatively, 43 (95.6%) patients in group I and 40 (95.2%) patients in group C had a grade 2 or 3 pivot shift ( P = .387). Postoperatively, 23 (53.5%) patients in group I and 38 (90.5%) patients in group C had a negative pivot shift ( P < .001). Group C showed a higher rate of return to the same level of sports activity than group I (57.1% vs 25.6%, respectively; P = .008), although there was no significant difference in the rate of return to any sports activity at the last follow-up (88.4% in group I vs 88.1% in group C; P = .713). Conclusion: Revision ACLR in combination with ALL reconstruction significantly reduced rotational laxity and showed a higher rate of return to the same level of sports activity than revision ACLR alone, although there were no significant differences in anterior laxity or functional test results between the 2 groups.

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Section: Discussionmentioning

confidence: 96%

Clinical Outcomes of Isolated Revision Anterior Cruciate Ligament Reconstruction or in Combination With Anatomic Anterolateral Ligament Reconstruction

et al. 2019

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“…One level I study was identified (3%) [41]. There was one level II prospective cohort study (3%) [50], 10 levels III (39%) [3, 27, 33, 38, 45, 52, 57, 61, 68, 69], and 16 level IV observational studies (55%) [1, 3–5, 13, 6, 14, 20, 21, 29, 34, 35, 43, 51, 52, 58, 68]. The methodological quality of non‐comparative studies scored 10.3 out of 16 points using the MINORS criteria (64% of maximum score).…”

Section: Resultsmentioning

confidence: 99%

“…One additional study was found by screening references. A total of 28 studies reporting on failure modes were ultimately included, including 24 cohort studies [1, 3–5, 13, 6, 14, 19–21, 29, 34, 38, 43, 45, 46, 51, 52, 57, 58, 62, 63, 68, 69] and four registry‐based studies [33, 35, 50, 61]. Fourteen of the 24 cohort studies reported age at time of primary reconstruction [1, 3, 5, 13, 19, 21, 22, 29, 39, 43, 51, 52, 54, 58].…”

Section: Resultsmentioning

confidence: 99%

Trauma and femoral tunnel position are the most common failure modes of anterior cruciate ligament reconstruction: a systematic review

Vermeijden

Yang

List

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To improve outcomes of anterior cruciate ligament reconstruction (ACLR), it is important to understand the reasons for failure of this procedure. This systematic review was performed to identify current failure modes of ACLR. Methods A systematic search was performed using PubMed, EMBASE, Cochrane, and annual registries for ACLR failures. Studies were included when failure modes were reported (I) of ≥ 10 patients and (II) at a minimum of two-year followup. Modes of failure were also compared between different graft types and in femoral tunnel positions. Results This review included 24 cohort studies and 4 registry-based studies (1 level I, 1 level II, 10 level III, and 16 level IV studies). Overall, a total of 3657 failures were identified. The most common single failure mode of ACLR was new trauma (38%), followed by technical errors (22%), combined causes (i.e. multiple failure mechanisms; 19%), and biological failures (i.e. failure due to infection or laxity without traumatic or technical considerations; 8%). Technical causes also played a contributing role in 17% of all failures. Femoral tunnel malposition was the most common cause of technical failure (63%). When specifically looking at the bone-patellar tendon-bone (BPTB) or hamstring (HT) autografts, trauma was the most common failure mode in both, whereas biological failure was more pronounced in the HT group (4% vs. 22%, respectively). Technical errors were more common following transtibial as compared to anteromedial portal techniques (49% vs. 26%). Conclusion Trauma is the single leading cause of ACLR failure, followed by technical errors, and combined causes. Technical errors seemed to play a major or contributing role in large part of reported failures, with femoral tunnel malposition being the leading cause of failure. Trauma was also the most common failure mode in both BPTB and HT grafts. Technical errors were a more common failure mode following transtibial than anteromedial portal technique. Level of evidence IV.

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“…A contralateral autologous graft harvest for ACL revision could be advantageous in order to avoid further donor site morbidity in the injured limb. Studies on contralateral hamstring (HT) harvest for ACL revision report this as a feasible option [33], with a similar clinical and patient-reported outcome compared with both ipsilateral HT harvest and allograft [34–36].…”

Section: Resultsmentioning

confidence: 99%

Outcome After Anterior Cruciate Ligament Revision

Horváth

Senorski

Westin

et al. 2019

Curr Rev Musculoskelet Med

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Purpose of Review To describe the current literature related to anterior cruciate ligament (ACL) revision in terms of surgical aspects, graft choices, concomitant injuries, patient-reported outcome, return to sport, and objective measurement outcome. Recent Findings An ACL rupture is a common knee injury, and the number of primary ACL reconstructions is increasing, implying a subsequent increase of ACL revisions in the future. It is widely accepted that an ACL revision is surgically challenging with a myriad of graft options to choose from. In many cases, simultaneous injuries to the index limb including meniscal and chondral lesions, respectively, are observed in the setting of a secondary ACL injury. Furthermore, the general understanding is that an ACL revision results in inferior outcome compared with a primary ACL reconstruction. Summary Surgical treatment of an ACL revision can be performed as one-stage or two-stage procedure depending on, for example, the presence of limb malalignments, concomitant injuries, and tunnel widening. Nonirradiated allografts and autologous patella tendon, hamstring tendon, and quadriceps tendon are feasible options for ACL revision. Concomitant injuries to the affected knee such as intraarticular chondral lesions are more common in the setting of an ACL revision compared with primary ACL reconstruction while a lower presence of concomitant meniscal pathology is reported at ACL revision. Patients undergoing ACL revision have lower clinical and patient-reported outcome and lower rates of return to sport when compared with primary ACL surgery cases. However, long-term follow-ups with large study cohorts evaluating outcome of ACL revision are limited. Further research is needed to confirm the present findings of this review.

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Revision anterior cruciate ligament reconstruction with ipsi- or contralateral hamstring tendon grafts

Cited by 18 publications

References 11 publications

Clinical Outcomes of Isolated Revision Anterior Cruciate Ligament Reconstruction or in Combination With Anatomic Anterolateral Ligament Reconstruction

Clinical Outcomes of Isolated Revision Anterior Cruciate Ligament Reconstruction or in Combination With Anatomic Anterolateral Ligament Reconstruction

Trauma and femoral tunnel position are the most common failure modes of anterior cruciate ligament reconstruction: a systematic review

Outcome After Anterior Cruciate Ligament Revision

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