Objectives: With the increasing number of primary anterior cruciate ligament (ACL) reconstructions, the need for revision ACL surgery has risen over the past few years. The purpose of the present study is to retrospectively compare the clinical outcome of ipsilateral versus contralateral hamstring tendon autografts for ACL revision surgery, specifically with regard to patient satisfaction, post-operative functional outcomes, and return to sports. Methods: Between 2004 and 2011, 64 patients underwent ACL revision surgery. Forty-five were successfully recontacted and retrospectively reviewed at an average follow-up of 6.3 years. Twenty-two subjects underwent revision ACL reconstruction with ipsilateral autogenous hamstring tendon grafts; in 23 subjects contralateral hamstring were used for reconstruction. Clinical, arthrometric, and functional evaluations were performed. The Tegner activity level, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) Subjective Knee Form were used. Objective evaluation included range of motion, Lachman test, pivot shift test and KT-1000 instrumented laxity testing. Results: No major complications were reported. Follow-up examination showed that there were no significant differences in the IKDC and KOOS scores between the groups. No differences in anterior tibial translation as measured with KT-1000 arthrometer were reported between the groups, although there was a trend for more of the patients undergoing ipsilateral DGST reconstruction to have a glide on the pivot shift test. The percentage of patients returning to pre-injury level was high in both groups. Conclusions: The use of contralateral hamstring tendon autografts for ACL revision surgery produced similar subjective and objective outcomes at 6-years follow-up compared to revision with ipsilateral hamstring tendon autografts. Patients undergoing revision surgery with contralateral autografts experienced a quicker return to sports compared to patients who underwent ipsilateral DGST revision surgery.

Revision anterior cruciate ligament reconstruction with ipsi- or contralateral hamstring tendon grafts / C. Legnani, G. Peretti, E. Borgo, S. Zini, A. Ventura. - In: EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY. - ISSN 1633-8065. - 27:4(2017 May), pp. 533-537. [10.1007/s00590-016-1894-4]

Revision anterior cruciate ligament reconstruction with ipsi- or contralateral hamstring tendon grafts

C. Legnani;G. Peretti;A. Ventura
2017

Abstract

Objectives: With the increasing number of primary anterior cruciate ligament (ACL) reconstructions, the need for revision ACL surgery has risen over the past few years. The purpose of the present study is to retrospectively compare the clinical outcome of ipsilateral versus contralateral hamstring tendon autografts for ACL revision surgery, specifically with regard to patient satisfaction, post-operative functional outcomes, and return to sports. Methods: Between 2004 and 2011, 64 patients underwent ACL revision surgery. Forty-five were successfully recontacted and retrospectively reviewed at an average follow-up of 6.3 years. Twenty-two subjects underwent revision ACL reconstruction with ipsilateral autogenous hamstring tendon grafts; in 23 subjects contralateral hamstring were used for reconstruction. Clinical, arthrometric, and functional evaluations were performed. The Tegner activity level, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) Subjective Knee Form were used. Objective evaluation included range of motion, Lachman test, pivot shift test and KT-1000 instrumented laxity testing. Results: No major complications were reported. Follow-up examination showed that there were no significant differences in the IKDC and KOOS scores between the groups. No differences in anterior tibial translation as measured with KT-1000 arthrometer were reported between the groups, although there was a trend for more of the patients undergoing ipsilateral DGST reconstruction to have a glide on the pivot shift test. The percentage of patients returning to pre-injury level was high in both groups. Conclusions: The use of contralateral hamstring tendon autografts for ACL revision surgery produced similar subjective and objective outcomes at 6-years follow-up compared to revision with ipsilateral hamstring tendon autografts. Patients undergoing revision surgery with contralateral autografts experienced a quicker return to sports compared to patients who underwent ipsilateral DGST revision surgery.
ACL revision surgery; anterior cruciate ligament; contralateral; ipsilateral; adolescent; adult; anterior cruciate ligament injuries; anterior cruciate ligament reconstruction; autografts; cohort studies; female; follow-up studies; graft survival; hamstring tendons; humans; joint instability; male; middle aged; range of motion, articular; reoperation; retrospective studies; risk assessment; tissue transplantation; treatment outcome; young adult; surgery; orthopedics and sports medicine
Settore MED/33 - Malattie Apparato Locomotore
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/588256
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