Outcomes after arthroscopic revision surgery for anterior cr
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The frequency of primary anterior cruciate ligament (ACL) reconstruction is increasing resulting in more ACL revision surgeries. Thus, an assessment was done to know about the survival rates of 2 different grafts for ACL revision surgery at 1- and 5-year follow-ups, as well as physical activity levels of patients after revision surgery.

A total of 218 patients (176 men) underwent revision surgery for anterior cruciate ligament injuries in this retrospective cohort study. A control group of 189 patients who had only primary surgery was used as a comparison. Surgical procedures were carried out using bone–patellar tendon–bone (BTB) and semitendinosus/gracilis (ST/G) autografts, as per normal practice. The Lysholm and International Knee Documentation Committee ratings were used to evaluate the outcomes of revision surgery at 1- and 5-year follow-ups.

--Malpositioned bone tunnels were found in 87/218 patients (40%).

--At 1 and 5 years postoperatively, the revision BTB group had significantly better results in terms of IKDC and Lysholm scores than the revision ST/G group (Mann–Whitney U-test), and these results were comparable to those in the comparison group.

--Graft survival after revision was lower than after the primary operation.

--However, the survival rate of 80% is quite high and is consistent with previous findings.

--There were no statistically reliable differences in survival between ST/G and BTB autografts.

The graft choice for revision ACL surgery should be decided upon before surgery based on, among other things, the state of bone tunnels, in particular their position and degree of bone resorption. Tunnel widening that exceeds 14?mm (osteolysis) would require 2-stage surgery using a BTB autograft with bone plugs because it is larger than the ST/G autograft.

Source: https://www.tandfonline.com/doi/full/10.1080/17453674.2021.1897744?af=R