One-stage revision anterior cruciate ligament reconstruction: Results according to preoperative bone tunnel diameter: Five to fifteen-year follow-up

Kyoung Ho Yoon, Jung Suk Kim, Soo Yeon Park, Sang Eon Park

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)

Abstract

Background: Bone tunnel enlargement is one of the important factors that determine whether a revision anterior cruciate ligament reconstruction (ACLR) should be performed in 1 or 2 stages. The goal of this retrospective cohort study was to compare the mid-term to long-term outcomes of 1-stage revision ACLR according to the amount of preoperative tunnel enlargement. Methods: Between January 2002 and January 2012, 88 patients who underwent revision ACLR were enrolled. The patients were divided into 2 groups based on the tunnel diameter (group A, <12 mm; group B, ‡12 mm). Clinical scores (International Knee Documentation Committee [IKDC] subjective score, Lysholm score, and Tegner score) and knee joint stability (as measured with the anterior drawer test, Lachman test, pivot-shift test, and measurement of the side-to-side difference in anterior tibial translation on Telos stress radiographs) were evaluated preoperatively and 5 to 15 years postoperatively. The failure rate and survivorship were compared between groups A and B. Results: The mean time to final follow-up was 7.9 ± 2.6 years. There were 44 patients in each of the 2 groups. There were no significant differences in the postoperative IKDC subjective scores, Lysholm scores, or Tegner activity scores between the groups. However, group A showed superior results on all knee joint stability tests except for the anterior drawer test. There were 3 failures in group A (7%) and 6 in group B (14%). The overall survival rates with failure as the end point were 93.1% and 84.6%, respectively, at 15 years. Conclusions: The 5 to 15-year clinical scores following revision ACLR did not differ significantly according to the preoperative amount of tunnel widening. However, the results of the postoperative Lachman and pivot-shift tests as well as the side-to-side difference in anterior tibial translation on Telos stress radiographs were significantly superior in the group with a preoperative tunnel diameter of <12 mm compared with the group with a tunnel diameter of ‡12 mm. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)993-1000
Number of pages8
JournalJournal of Bone and Joint Surgery - Series A
Volume100
Issue number12
DOIs
Publication statusPublished - 1 Jun 2018

Bibliographical note

Publisher Copyright:
© 2018 By the Journal of Bone and Joint Surgery, Incorporated

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