Second revision of anterior cruciate ligament reconstruction using achilles tendon allograft: a case series of 20 patients at mid-term follow-up.

IF 3.7 2区 医学 Q1 ORTHOPEDICS
Francesco Pettinari, Mattia Chirico, Alessandra Mazzon, Jacopo Corti, Andrea Di Muro, Roberto Civinini, Fabrizio Matassi
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引用次数: 0

Abstract

Purpose: This study aimed to evaluate the clinical outcomes, failure rates, and complications associated with a second revision anterior cruciate ligament reconstruction using an Achilles tendon allograft in a mono-loop fashion, which allows simultaneous reconstruction of the anterior cruciate ligament and the anterolateral ligament. The hypothesis was that this combined technique is safe and leads to satisfactory clinical outcomes at mid-term follow-up.

Methods: A retrospective analysis was conducted on 20 patients who underwent a second revision ACL reconstruction between January 2018 and December 2022. All patients received an Achilles tendon allograft with a bone plug, used in a mono-loop technique to reconstruct both ACL and ALL. Exclusion criteria included multi-ligament injuries, posterior tibial slope > 12°, or follow-up shorter than 24 months. Clinical evaluation included pre- and postoperative scores: Tegner, subjective IKDC, Lysholm, and KOOS, as well as physical examination and Rolimeter testing. Mean follow-up was 32.2 months.

Results: The mean patient age was 36.8 ± 6.3 years. All clinical scores improved postoperatively: Tegner (from 64.3 to 87), subjective IKDC (55.1 to 64.4), Lysholm (58.2 to 76.9), and KOOS (59.7 to 70.1). Anteroposterior laxity decreased from 7.2 ± 2.1 mm preoperatively to 1.2 ± 1.3 mm postoperatively. A total of 55% of patients returned to their desired sports level, 25% to a lower level, and only one patient (5%) did not return owing to residual laxity. No postoperative complications or re-revisions were reported.

Conclusions: The mono-loop technique for simultaneous ACL and ALL reconstruction using an Achilles tendon allograft during a second revision procedure is safe and effective. It results in satisfactory mid-term outcomes, low failure rates, and no significant complications, providing a viable single-stage alternative for complex revision cases.

Study design: Cohort study; Level of evidence, 3.

采用同种异体跟腱重建前交叉韧带的第二次翻修:20例患者中期随访。
目的:本研究旨在评估使用跟腱同种异体单环方式进行第二次翻修前十字韧带重建的临床结果、失败率和并发症,该方法允许同时重建前十字韧带和前外侧韧带。假设这种联合技术是安全的,并且在中期随访中导致令人满意的临床结果。方法:回顾性分析2018年1月至2022年12月期间接受第二次ACL重建的20例患者。所有患者均接受带骨栓的跟腱异体移植,采用单环技术重建ACL和All。排除标准包括多韧带损伤、胫骨后斜度小于12°或随访时间小于24个月。临床评估包括术前和术后评分:Tegner、主观IKDC、Lysholm和kos,以及体格检查和Rolimeter测试。平均随访32.2个月。结果:患者平均年龄36.8±6.3岁。术后所有临床评分均有改善:Tegner(从64.3到87)、主观IKDC(从55.1到64.4)、Lysholm(从58.2到76.9)和kos(从59.7到70.1)。前后关节松弛度由术前7.2±2.1 mm降至术后1.2±1.3 mm。总共55%的患者恢复到他们期望的运动水平,25%的患者恢复到更低的运动水平,只有1名患者(5%)由于残余松弛而没有恢复。无术后并发症或再修报告。结论:单环技术在第二次翻修手术中使用同种异体跟腱同时重建ACL和ALL是安全有效的。中期结果令人满意,失败率低,无明显并发症,为复杂的翻修病例提供了可行的单阶段替代方案。研究设计:队列研究;证据水平,3。
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
Journal of Orthopaedics and Traumatology
Journal of Orthopaedics and Traumatology Medicine-Orthopedics and Sports Medicine
CiteScore
4.30
自引率
0.00%
发文量
56
审稿时长
13 weeks
期刊介绍: The Journal of Orthopaedics and Traumatology, the official open access peer-reviewed journal of the Italian Society of Orthopaedics and Traumatology, publishes original papers reporting basic or clinical research in the field of orthopaedic and traumatologic surgery, as well as systematic reviews, brief communications, case reports and letters to the Editor. Narrative instructional reviews and commentaries to original articles may be commissioned by Editors from eminent colleagues. The Journal of Orthopaedics and Traumatology aims to be an international forum for the communication and exchange of ideas concerning the various aspects of orthopaedics and musculoskeletal trauma.
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