Revision anterior cruciate ligament surgery: experience from Germany

From 1976 to 1992, reconstruction after failed anterior cruciate ligament repair or reconstruction was done for 87 patients (8%) compared with 1064 primary operations at the authors' institution. Fifty-seven patients had 1 previous reconstruction, 27 patients had 2, and 3 patients had 3 or more previous reconstructions. Fifty-two patients (60%) were satisfied with their results after a mean followup time of 8 years (range, 2-18 years). Lysholm scores after revisions (68 +/- 12) were significantly inferior compared with scores after primary anterior cruciate ligament surgery (83 +/- 14). The authors favor the use of the patellar tendon or quadriceps tendon autograft in revision surgery. Medial meniscus reconstruction is done whenever possible, or the medial meniscus is replaced by autograft tissue. Open or arthroscopic techniques are used, depending on the individual case.