Single-Stage Revision Anterior Cruciate Ligament Reconstruction: Experience With 91 Patients (40 Elite Athletes)...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Rising prevalence of anterior cruciate ligament (ACL) reconstruction necessitates effective revision procedures.
• Growing evidence supports single-stage revision ACL reconstruction, yet specific guidelines for its safe execution are lacking.

Purpose of the Study:

• To evaluate outcomes, graft failure, and return-to-play rates using a decision-making algorithm for single-stage revision ACL reconstruction.

Main Methods:

• A consecutive series of revision ACL reconstructions (September 2009-July 2016) were reviewed with a minimum 2-year follow-up.
• Patient assessment and surgical decisions followed a defined algorithm.
• Outcomes included re-operation, graft rerupture, re-revision, Tegner score, and Knee injury and Osteoarthritis Outcome Score (KOOS). Return-to-play data was collected for elite athletes.

Main Results:

• 91 single-stage revision ACL reconstructions were analyzed.
• The study observed a 4.4% total graft failure rate and a 2.2% re-revision rate at a mean 4.3-year follow-up.
• Mean Tegner score remained high (7.1), and Knee injury and Osteoarthritis Outcome Score (KOOS) demonstrated favorable results across all subscales.
• 35 of 40 elite athletes returned to play at a mean of 11.2 months post-surgery.

Conclusions:

• Single-stage revision ACL reconstruction is a reliable procedure for most patients.
• The technique yields good clinical outcomes, low graft rerupture rates, and high return-to-play rates, including in elite athletes.