Cargando…
Allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes
PURPOSE: Multiple studies have shown higher failure rate and patient-reported outcomes to be significantly worse following revision anterior cruciate ligament reconstructive (ACLR) surgery, especially using allografts. One of the reasons being rotational instability. Because of this, augmentation wi...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Paris
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10368563/ https://www.ncbi.nlm.nih.gov/pubmed/36708388 http://dx.doi.org/10.1007/s00590-023-03475-4 |
_version_ | 1785077532750512128 |
---|---|
author | Minguell Monyart, Joan Moreira Borim, Felipe Revertè Vinaixa, Maria Mercedes Portas-Torres, Irene Pijoan Bueno, Joan Castellet Feliu, Enric Joshi Jubert, Nayana |
author_facet | Minguell Monyart, Joan Moreira Borim, Felipe Revertè Vinaixa, Maria Mercedes Portas-Torres, Irene Pijoan Bueno, Joan Castellet Feliu, Enric Joshi Jubert, Nayana |
author_sort | Minguell Monyart, Joan |
collection | PubMed |
description | PURPOSE: Multiple studies have shown higher failure rate and patient-reported outcomes to be significantly worse following revision anterior cruciate ligament reconstructive (ACLR) surgery, especially using allografts. One of the reasons being rotational instability. Because of this, augmentation with lateral extra-articular tenodesis (LET) is often considered. Good short-term results in regards to functional and perceived scores and low complication rate can be expected in revision ACLR using allografts in combination with LET. METHODS: Between 2014 and 2021, 46 patients were registered for revision ACLR using allografts and extra-articular augmentation (modified Lemaire) and included in this prospective study. Patients’ demographic and clinical data were collected preoperatively, postoperatively, and during the follow-up period of 12 months. RESULTS: Patient-reported functional outcomes were statistically significant for IKDC, Lysholm, and SF-12 physical scale (p < 0.05). Tegner score showed a decreased number of patients who were able to return to sport at their previous level (p = 0.001). Stability examination tests (Lachman and pivot-shift) showed significant improvements. Concomitant lesions were present in 76.1% of patients. Ten patients (21.7%) presented major complications, including six cases of anteroposterior instability, three cases of knee pain and one graft re-rupture. CONCLUSION: Revision procedures are inherently challenging with a high number of associated chondral and meniscus lesions. However, good short-term functional outcomes and enhanced rotational stability with an acceptable complication rate can be expected in most cases where revision ACLR using allografts is augmented with LET. STUDY DESIGN: Prospective; Case series; Level of evidence IV. |
format | Online Article Text |
id | pubmed-10368563 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Paris |
record_format | MEDLINE/PubMed |
spelling | pubmed-103685632023-07-27 Allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes Minguell Monyart, Joan Moreira Borim, Felipe Revertè Vinaixa, Maria Mercedes Portas-Torres, Irene Pijoan Bueno, Joan Castellet Feliu, Enric Joshi Jubert, Nayana Eur J Orthop Surg Traumatol Original Article PURPOSE: Multiple studies have shown higher failure rate and patient-reported outcomes to be significantly worse following revision anterior cruciate ligament reconstructive (ACLR) surgery, especially using allografts. One of the reasons being rotational instability. Because of this, augmentation with lateral extra-articular tenodesis (LET) is often considered. Good short-term results in regards to functional and perceived scores and low complication rate can be expected in revision ACLR using allografts in combination with LET. METHODS: Between 2014 and 2021, 46 patients were registered for revision ACLR using allografts and extra-articular augmentation (modified Lemaire) and included in this prospective study. Patients’ demographic and clinical data were collected preoperatively, postoperatively, and during the follow-up period of 12 months. RESULTS: Patient-reported functional outcomes were statistically significant for IKDC, Lysholm, and SF-12 physical scale (p < 0.05). Tegner score showed a decreased number of patients who were able to return to sport at their previous level (p = 0.001). Stability examination tests (Lachman and pivot-shift) showed significant improvements. Concomitant lesions were present in 76.1% of patients. Ten patients (21.7%) presented major complications, including six cases of anteroposterior instability, three cases of knee pain and one graft re-rupture. CONCLUSION: Revision procedures are inherently challenging with a high number of associated chondral and meniscus lesions. However, good short-term functional outcomes and enhanced rotational stability with an acceptable complication rate can be expected in most cases where revision ACLR using allografts is augmented with LET. STUDY DESIGN: Prospective; Case series; Level of evidence IV. Springer Paris 2023-01-28 2023 /pmc/articles/PMC10368563/ /pubmed/36708388 http://dx.doi.org/10.1007/s00590-023-03475-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Minguell Monyart, Joan Moreira Borim, Felipe Revertè Vinaixa, Maria Mercedes Portas-Torres, Irene Pijoan Bueno, Joan Castellet Feliu, Enric Joshi Jubert, Nayana Allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes |
title | Allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes |
title_full | Allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes |
title_fullStr | Allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes |
title_full_unstemmed | Allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes |
title_short | Allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes |
title_sort | allografts and lateral extra-articular tenodesis for revision anterior cruciate ligament reconstruction: enhanced rotational stability and improved functional outcomes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10368563/ https://www.ncbi.nlm.nih.gov/pubmed/36708388 http://dx.doi.org/10.1007/s00590-023-03475-4 |
work_keys_str_mv | AT minguellmonyartjoan allograftsandlateralextraarticulartenodesisforrevisionanteriorcruciateligamentreconstructionenhancedrotationalstabilityandimprovedfunctionaloutcomes AT moreiraborimfelipe allograftsandlateralextraarticulartenodesisforrevisionanteriorcruciateligamentreconstructionenhancedrotationalstabilityandimprovedfunctionaloutcomes AT revertevinaixamariamercedes allograftsandlateralextraarticulartenodesisforrevisionanteriorcruciateligamentreconstructionenhancedrotationalstabilityandimprovedfunctionaloutcomes AT portastorresirene allograftsandlateralextraarticulartenodesisforrevisionanteriorcruciateligamentreconstructionenhancedrotationalstabilityandimprovedfunctionaloutcomes AT pijoanbuenojoan allograftsandlateralextraarticulartenodesisforrevisionanteriorcruciateligamentreconstructionenhancedrotationalstabilityandimprovedfunctionaloutcomes AT castelletfeliuenric allograftsandlateralextraarticulartenodesisforrevisionanteriorcruciateligamentreconstructionenhancedrotationalstabilityandimprovedfunctionaloutcomes AT joshijubertnayana allograftsandlateralextraarticulartenodesisforrevisionanteriorcruciateligamentreconstructionenhancedrotationalstabilityandimprovedfunctionaloutcomes |