Patients submitted to re-revision ACL reconstruction present more knee laxity, more complications, and a higher failure rate than patients submitted to the first revision ACL reconstruction

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2024-11-21 DOI:10.1016/j.knee.2024.11.004

Camilo Partezani Helito , Andre Giardino Moreira da Silva , Riccardo Cristiani , Anders Stålman , Vitor Barion Castro de Pádua , Riccardo Gomes Gobbi , José Ricardo Pécora

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引用次数: 0

Abstract

Background

Few comparative studies have evaluated patients who underwent two revision anterior cruciate ligament reconstruction (ACLR) and patients who underwent one revision ACLR, and many of them have a short postoperative follow-up and a relatively small number of patients. The objective of this study is to evaluate the functional results, complications, and failure rates of patients who underwent one revision ACLR and patients who underwent two revision ACLRs.

Methods

This is a retrospective study comparing patients who underwent one revision ACLR (Group 1) with patients who underwent a re-revision ACLR (Group 2). Baseline demographic variables, operative data and post-operative data were evaluated.

Results

Among the 266 patients included, 226 were from Group 1 and 40 from Group 2. Patients in Group 2 had greater rotatory laxity and were more often subjected to associated osteotomy at the time of revision surgery. Postoperatively, patients from Group 2 reported poorer subjective IKDC score and showed greater knee laxity measured with the KT-1000 arthrometer, although both probably not clinically relevant. The complication rate was high in both groups, with a higher incidence in Group 2. Reconstruction failures were also higher in Group 2 (20% vs. 8.8%, p = 0.03).

Conclusion

Patients from Group 2 underwent a higher rate of associated osteotomy procedures, present higher complication rates and a higher failure rate compared with patients from Group 1. However, the functional scores (Lysholm and IKDC score) and the physical examination (KT-1000 and pivot-shift) did not show clinically relevant differences between the groups.

Level of Evidence

III, retrospective comparative therapeutic trial.

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与接受首次前交叉韧带翻修重建术的患者相比，接受再次前交叉韧带翻修重建术的患者膝关节更松弛，并发症更多，失败率更高。

背景：很少有比较研究对接受过两次翻修前交叉韧带重建术（ACLR）的患者和接受过一次翻修前交叉韧带重建术的患者进行评估，而且许多研究的术后随访时间较短，患者人数相对较少。本研究旨在评估接受过一次翻修前交叉韧带重建术的患者和接受过两次翻修前交叉韧带重建术的患者的功能效果、并发症和失败率：这是一项回顾性研究，比较了接受过一次前交叉韧带翻修术的患者（第 1 组）和接受过一次前交叉韧带翻修术的患者（第 2 组）。对基线人口统计学变量、手术数据和术后数据进行了评估：在266名患者中，第一组有226人，第二组有40人。第二组患者的旋转松弛度更大，在翻修手术时更常需要进行相关的截骨手术。术后，第2组患者的IKDC主观评分较低，用KT-1000关节测量仪测量的膝关节松弛度较大，但这两点可能与临床无关。两组患者的并发症发生率都很高，其中第 2 组的发生率更高。第二组的重建失败率也更高（20% 对 8.8%，P = 0.03）：结论：与第1组患者相比，第2组患者接受相关截骨手术的比例更高，并发症发生率更高，失败率更高：证据等级：III，回顾性比较治疗试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.