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Revision ACL reconstruction using autogenous patellar tendon graft.
C Eberhardt1, A H Kurth, N Hailer
1Department of Orthopedic Surgery, Friedrichsheim Frankfurt University Hospital, Germany.
Summary
Revision anterior cruciate ligament reconstruction with patellar tendon grafts significantly improves knee stability and function. However, osteoarthritis progression is more likely in patients with pre-existing cartilage damage or synovitis.
Area of Science:
- Orthopedic surgery
- Sports medicine
- Biomedical engineering
Background:
- Anterior cruciate ligament (ACL) injuries often require revision surgery.
- Patellar tendon autografts are a common choice for ACL reconstruction.
- Assessing outcomes of revision ACL reconstruction is crucial for patient management.
Purpose of the Study:
- To evaluate the clinical and radiographic outcomes of revision ACL reconstruction using bone-tendon-bone patellar tendon autografts.
- To identify factors influencing osteoarthritis progression after revision ACL reconstruction.
Main Methods:
- Retrospective study of 44 patients undergoing revision ACL reconstruction.
- Follow-up averaged 41.2 months.
- Clinical assessments included Lachman and pivot shift tests, KT-1000 arthrometry, Lysholm score, Tegner activity score, IKDC ranking, and modified Fairbank osteoarthritis scale.
Main Results:
- Significant improvements in knee stability and function were observed.
- Median Lysholm score was 85, median Tegner score was 5.0.
- 75% of knees were rated normal or nearly normal (IKDC grades A/B).
- 36.4% showed radiographic osteoarthritis progression.
- Major cartilage lesions and extensive synovitis were associated with increased osteoarthritis progression (P<0.05).
Conclusions:
- Revision ACL reconstruction with patellar tendon autografts yields good functional results.
- Osteoarthritis progression is a concern, particularly in patients with significant preoperative cartilage damage or synovitis.