The Effect of Technical Characteristics of Revision ACL Reconstruction on Functional Outcomes

Advances in arthroscopic techniques have increased the global prevalence of anterior cruciate ligament reconstruction (ACLR) surgeries. Despite this, failure rates remain high, with revision ACLR (R-ACLR) often yielding inferior outcomes compared to primary procedures. This study aimed to investigate the correlation between the technical characteristics of R-ACLR and functional outcomes.

This retrospective study analyzed 46 revision ACLRs performed at the 3^rd step medical department between 2000 and 2017. Patient demographics, surgical history, and imaging findings were collected. Outcomes were assessed through physical examinations, Tegner-Lysholm Knee scales, and radiographic evaluations. Statistical analyses, including t-tests and ANOVA, were conducted using SPSS v26, with a significance level of p<0.05.

A total of 46 procedures were analyzed. The mean follow-up duration was 77.9 months. Failure after primary ACLR occurred at a median of 45.6 months due to trauma and 25.5 months due to technical errors. The techniques included transtibial (28.2%), modified transtibial (19.6%), and anteromedial portal (52.2%). At the final follow-up, the mean Tegner-Lyshom Score was 73.5. Significant correlations were observed for graft thickness (r=0.650, p=0.001), postoperative Lachman test (r=-0.727, p=0.001), KT1000 measurement (r=-0.581, p=0.001), and femoral tunnel obliquity (r=0.511, p=0.001).

Revision ACLR may successfully restore knee stability, and functional outcomes are influenced by graft size, knee stability, and femoral tunnel obliquity. Understanding the causes of reduced functional scores is crucial to prevent patient dissatisfaction.