AJSM Click here for details!
HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Sign In to gain access to subscriptions and/or personal tools.
First published on February 13, 2008, doi:10.1177/0363546507312381
This version was published on May 1, 2008
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
36/5/851    most recent
0363546507312381v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Diamantopoulos, A. P.
Right arrow Articles by Paessler, H. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Diamantopoulos, A. P.
Right arrow Articles by Paessler, H. H.
Related Collections
Right arrow Degenerative Joint Disease
Right arrow Reconstruction
The American Journal of Sports Medicine 36:851-860 (2008)
© 2008 American Orthopaedic Society for Sports Medicine

Anterior Cruciate Ligament Revision Reconstruction

Results in 107 Patients

Andreas P. Diamantopoulos, MD{dagger},*, Olaf Lorbach, MD{ddagger} and Hans H. Paessler, MD{dagger}

From the {dagger} ATOS Clinic, Centre of Knee and Foot Surgery, Sportstrauma, Heidelberg, Germany, and the {ddagger} Department of Orthopaedic Surgery, University of Homburg/Saar, Germany

* Address correspondence to Andreas Diamantopoulos, Vas. Sofias 54, Athens, Greece 11528 (e-mail: andreas_d{at}gmx.net).

Background: Although techniques and options for suitable graft substitutes for anterior cruciate ligament surgery continue to improve, failures occur because of many reasons. Errors in surgical techniques seem to be important reasons.

Hypothesis: Inappropriate positioning of the tunnels may be the most important reason for these failures. Anatomical anterior cruciate ligament revision reconstruction, using autografts, may yield acceptable outcomes.

Study design: Case series; Level of evidence, 4.

Methods: This retrospective study involved 148 anterior cruciate ligament revision reconstructions performed in our hospital using autografts. One hundred and seven patients were followed up at a mean of 72.9 ± 20.6 months. Clinical evaluation was performed using the Lysholm score, the Tegner rating system, the International Knee Documentation Committee evaluation form, and the KT-1000 arthrometer. Radiographs were evaluated for signs of osteoarthritis according to the Jaeger and Wirth classification.

Results: Inappropriate positioning of the tunnels was the most important reason (63.5%) for anterior cruciate ligament reconstruction failure. The average Lysholm score improved significantly at the follow-up (88.5 ± 12.4 vs 51.5 ± 24.9; P < .001). Moreover, the average Tegner activity score improved significantly compared with the activity score before revision surgery (6.3 ± 1.8 vs 2.8 ± 1.8; P < .001). The International Knee Documentation Committee score was A in 17 cases, B in 45, C in 37, and D in 8. Radiographic evaluation revealed that 33 patients had degenerative findings of grade I, 35 of grade II, 16 of grade III, and 2 of grade IV.

Conclusion: Anatomical anterior cruciate ligament revision reconstruction provides satisfactory midterm results as far as stability and function of the knee are concerned. In spite of these favorable subjective and objective results, the radiological evaluation revealed a significant progression of osteoarthritis.

Key Words: anterior cruciate ligament • revision surgery • autografts • failure • tunnel placement • osteoarthritis






HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the American Orthopaedic Society for Sports Medicine.