Combined intra- and extra-articular grafting for revision ACL reconstruction: A multicentre study by the French Arthroscopy Society (SFA) - 19/12/17
, P. D’ingrado b, F.P. Ehkirch c, S. Bertiaux d, P. Colombet e, B. Sonnery-Cottet f, B. Schlatterer g, R. Pailhé n, J.C. Panisset h, C. Steltzlen i, S. Lustig j, C. Lutz k, F. Dalmay l, P. Imbert m, D. Saragaglia nthe French Arthroscopy Society (Société Francophone d’Arthroscopie, SFA)
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Abstract |
Background |
A careful analysis of the reasons for ACL reconstruction failure is essential to selection of the optimal surgical revision technique designed to ensure good rotational stability and to minimise the risk of re-rupture.
Objective |
To evaluate anterolateral ligament (ALL) stabilisation during revision ACL reconstruction.
Hypothesis |
ALL stabilisation during revision ACL reconstruction provides good rotational stability without increasing the risk of complications.
Material and methods |
This multicentre study included 349 patients, 151 retrospectively and 198 prospectively. There were 283 males and 66 females. Inclusion criteria were an indication for revision ACL reconstruction surgery with combined intra-articular reconstruction and ALL stabilisation after failed autograft ACL reconstruction, and intact PCL. Exclusion criteria were primary ACL reconstruction and concomitant peripheral medial and/or lateral lesions. Each patient underwent a clinical and radiographic evaluation before and after revision surgery. Before revision surgery, the mean IKDC score was 56.5±15.5 and 96% of patients were IKDC C or D.
Results |
Rates were 5.0% for early and 10.5% for late postoperative complications. Lachmann's test had a hard stop at last follow-up in 97% of patients. The pivot-shift test was positive in 1% of patients. The mean subjective IKDC score was 84.5±13.0 and 86.5% of patients were IKDC A or B. The proportions of patients with radiographic knee osteoarthritis at last follow-up was unchanged for the lateral tibio-femoral and patello-femoral compartments but increased by 9.7% to 21.2% for the medial tibio-femoral compartment. The re-rupture rate was 1.2% and the further surgical revision rate was 5.4%.
Conclusion |
Anterior laxity at last follow-up was consistent with previous studies of revision ACL reconstruction. However, rotational stability and the re-rupture risk were improved. ALL stabilisation is among the techniques that deserve consideration as part of the therapeutic options for revision ACL reconstruction.
Level of evidence |
IV, retrospective and prospective cohort study.
Le texte complet de cet article est disponible en PDF.Keywords : Anterior cruciate ligament, Anterolateral ligament, Lateral tenodesis, Revision ACL reconstruction
Plan
Vol 103 - N° 8S
P. S223-S229 - décembre 2017 Retour au numéro
Article précédent
- Midterm results of combined intra- and extra-articular ACL reconstruction compared to historical ACL reconstruction data. Multicenter study of the French Arthroscopy Society
- P. Imbert, S. Lustig, C. Steltzlen, C. Batailler, P. Colombet, F. Dalmay, S. Bertiaux, P. D’ingrado, F.P. Ehkirch, M.L. Louis, R. Pailhé, J.C. Panisset, B. Schlaterrer, B. Sonnery-Cottet, L. Sigwalt, D. Saragaglia, C. Lutz, the French Arthroscopy Society
- Short-term complications in intra- and extra-articular anterior cruciate ligament reconstruction. Comparison with the literature on isolated intra-articular reconstruction. A multicenter study by the French Arthroscopy Society
- J.C. Panisset, R. Pailhé, B. Schlatterer, L. Sigwalt, B. Sonnery-Cottet, C. Lutz, S. Lustig, C. Batailler, S. Bertiaux, F.P. Ehkirch, P. Colombet, C. Steltzlen, M.L. Louis, P. D’ingrado, F. Dalmay, P. Imbert, D. Saragaglia, French Arthroscopy Society
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