Objective postoperative knee stability after 1-stage and 2-stage revision anterior cruciate ligament reconstruction

Revision anterior cruciate ligament reconstruction (ACLR) procedures are performed either as 1-stage or 2-stage surgeries. But there has been no report of comparison in postoperative knee stability between 1-stage and 2-stage Revision ACLR. Therefore, the present study aimed to compare postoperative anterior stability after 1-stage and 2-stage surgeries.

Objective anterior knee laxity was evaluated by knee arthrometer at 12+ months postoperatively among 35 patients who underwent revision ACLR.

19 patients (Group 1: nine males and 10 females, mean age 26.4 ± 11.0 years) underwent 1-stage revision ACLR and 16 patients (12 males and four females, mean age 32.3 ± 10.6 years) underwent 2-stage revision ACLR with staged revision ACLR at six months after iliac bone grafting for large bone defects. At the final follow-up period (23 ± 9 months after 1-stage surgery and 21 ± 9 months after 2-stage surgery), procedures in two patients (10.5 %) after 1-stage surgery and one patient (6.7 %) after 2-stage surgery were found to have failed. KT side-to-side differences in anterior laxity at manual maximum force were 0.9 ± 1.1 mm and 0.9 ± 1.3 mm after 1- and 2-stage surgeries, respectively, with 94 % of patients after 1-stage surgery and 80 % of patients after 2-stage surgery showing anterior laxity values between -1 and 2 mm. We found no significant technique-dependent difference in objective anterior knee laxity between 1-stage and 2-stage revision ACLR.

After a minimum of 12 months of follow-up, patients who underwent 1-stage and 2-stage revision ACLR acquired sufficient knee stability regardless of surgical technique, showing no other significant differences.