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One-Stage Revision Anterior Cruciate Ligament Reconstruction: Results According to Preoperative Bone Tunnel Diameter
- Source :
- Journal of Bone and Joint Surgery. 100:993-1000
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Bone tunnel enlargement is one of the important factors that determine whether a revision anterior cruciate ligament reconstruction (ACLR) should be performed in 1 or 2 stages. The goal of this retrospective cohort study was to compare the mid-term to long-term outcomes of 1-stage revision ACLR according to the amount of preoperative tunnel enlargement.Between January 2002 and January 2012, 88 patients who underwent revision ACLR were enrolled. The patients were divided into 2 groups based on the tunnel diameter (group A,12 mm; group B, ≥12 mm). Clinical scores (International Knee Documentation Committee [IKDC] subjective score, Lysholm score, and Tegner score) and knee joint stability (as measured with the anterior drawer test, Lachman test, pivot-shift test, and measurement of the side-to-side difference in anterior tibial translation on Telos stress radiographs) were evaluated preoperatively and 5 to 15 years postoperatively. The failure rate and survivorship were compared between groups A and B.The mean time to final follow-up was 7.9 ± 2.6 years. There were 44 patients in each of the 2 groups. There were no significant differences in the postoperative IKDC subjective scores, Lysholm scores, or Tegner activity scores between the groups. However, group A showed superior results on all knee joint stability tests except for the anterior drawer test. There were 3 failures in group A (7%) and 6 in group B (14%). The overall survival rates with failure as the end point were 93.1% and 84.6%, respectively, at 15 years.The 5 to 15-year clinical scores following revision ACLR did not differ significantly according to the preoperative amount of tunnel widening. However, the results of the postoperative Lachman and pivot-shift tests as well as the side-to-side difference in anterior tibial translation on Telos stress radiographs were significantly superior in the group with a preoperative tunnel diameter of12 mm compared with the group with a tunnel diameter of ≥12 mm.Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Knee Joint
Anterior cruciate ligament reconstruction
medicine.medical_treatment
Young Adult
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Orthopedics and Sports Medicine
Femur
Retrospective Studies
030222 orthopedics
Anterior Cruciate Ligament Reconstruction
business.industry
Anterior Cruciate Ligament Injuries
One stage
Retrospective cohort study
030229 sport sciences
General Medicine
Middle Aged
Surgery
Bone tunnel
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15351386 and 00219355
- Volume :
- 100
- Database :
- OpenAIRE
- Journal :
- Journal of Bone and Joint Surgery
- Accession number :
- edsair.doi.dedup.....6885c072951a5854908039062719fa10