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Outcomes after arthroscopic revision surgery for anterior cruciate ligament injuries

Background and purpose — The frequency of primary anterior cruciate ligament (ACL) reconstruction is increasing resulting in more ACL revision surgeries. Therefore, we assessed survival rates of 2 different grafts for ACL revision surgery at 1- and 5-year follow-ups, as well as physical activity lev...

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Autores principales: Yumashev, Alexei V, Baltina, Tatyana V, Babaskin, Dmitrii V
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8381895/
https://www.ncbi.nlm.nih.gov/pubmed/33739222
http://dx.doi.org/10.1080/17453674.2021.1897744
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author Yumashev, Alexei V
Baltina, Tatyana V
Babaskin, Dmitrii V
author_facet Yumashev, Alexei V
Baltina, Tatyana V
Babaskin, Dmitrii V
author_sort Yumashev, Alexei V
collection PubMed
description Background and purpose — The frequency of primary anterior cruciate ligament (ACL) reconstruction is increasing resulting in more ACL revision surgeries. Therefore, we assessed 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. Patients and methods — This is a retrospective cohort study involving 218 patients (176 males) who had revision surgery for anterior cruciate ligament injuries between 2008 and 2017 at the Clinic of Traumatology, Orthopedics and Joint Pathology Clinic (I.M. Sechenov First Moscow State Medical University). A comparison group involved 189 patients with only primary surgery. Surgical interventions were performed according to the standard procedure using bone–patellar tendon–bone (BTB) and semitendinosus/gracilis (ST/G) autografts. The results of revision surgery were assessed at 1- and 5-year follow-ups by using the Lysholm and International Knee Documentation Committee scores. Results — 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 (p = 0.03, 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. Interpretation — 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.
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spelling pubmed-83818952021-08-24 Outcomes after arthroscopic revision surgery for anterior cruciate ligament injuries Yumashev, Alexei V Baltina, Tatyana V Babaskin, Dmitrii V Acta Orthop Research Article Background and purpose — The frequency of primary anterior cruciate ligament (ACL) reconstruction is increasing resulting in more ACL revision surgeries. Therefore, we assessed 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. Patients and methods — This is a retrospective cohort study involving 218 patients (176 males) who had revision surgery for anterior cruciate ligament injuries between 2008 and 2017 at the Clinic of Traumatology, Orthopedics and Joint Pathology Clinic (I.M. Sechenov First Moscow State Medical University). A comparison group involved 189 patients with only primary surgery. Surgical interventions were performed according to the standard procedure using bone–patellar tendon–bone (BTB) and semitendinosus/gracilis (ST/G) autografts. The results of revision surgery were assessed at 1- and 5-year follow-ups by using the Lysholm and International Knee Documentation Committee scores. Results — 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 (p = 0.03, 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. Interpretation — 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. Taylor & Francis 2021-03-19 /pmc/articles/PMC8381895/ /pubmed/33739222 http://dx.doi.org/10.1080/17453674.2021.1897744 Text en © 2021 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Yumashev, Alexei V
Baltina, Tatyana V
Babaskin, Dmitrii V
Outcomes after arthroscopic revision surgery for anterior cruciate ligament injuries
title Outcomes after arthroscopic revision surgery for anterior cruciate ligament injuries
title_full Outcomes after arthroscopic revision surgery for anterior cruciate ligament injuries
title_fullStr Outcomes after arthroscopic revision surgery for anterior cruciate ligament injuries
title_full_unstemmed Outcomes after arthroscopic revision surgery for anterior cruciate ligament injuries
title_short Outcomes after arthroscopic revision surgery for anterior cruciate ligament injuries
title_sort outcomes after arthroscopic revision surgery for anterior cruciate ligament injuries
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8381895/
https://www.ncbi.nlm.nih.gov/pubmed/33739222
http://dx.doi.org/10.1080/17453674.2021.1897744
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