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Outcome After Anterior Cruciate Ligament Revision

Journal article
Authors Alexandra Horvath
Eric Hamrin Senorski
Olof Westin
Jón Karlsson
Kristian Samuelsson
Eleonor Svantesson
Published in Current Reviews in Musculoskeletal Medicine
Volume 12
Issue 3
Pages 397-405
ISSN 1935-973X
Publication year 2019
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Institute of Clinical Sciences, Department of Orthopaedics
Pages 397-405
Language en
Keywords Anterior cruciate ligament, Revision, Concomitant injury, Graft choice, Patient-reported outcome, Return to sport, quadriceps tendon autograft, multicenter acl revision, patellar tendon, hamstring tendon, reconstruction surgery, graft choice, risk-factors, donor-site, return, metaanalysis, Orthopedics
Subject categories Orthopedics


Purpose of Review To describe the current literature related to anterior cruciate ligament (ACL) revision in terms of surgical aspects, graft choices, concomitant injuries, patient-reported outcome, return to sport, and objective measurement outcome. Recent Findings An ACL rupture is a common knee injury, and the number of primary ACL reconstructions is increasing, implying a subsequent increase of ACL revisions in the future. It is widely accepted that an ACL revision is surgically challenging with a myriad of graft options to choose from. In many cases, simultaneous injuries to the index limb including meniscal and chondral lesions, respectively, are observed in the setting of a secondary ACL injury. Furthermore, the general understanding is that an ACL revision results in inferior outcome compared with a primary ACL reconstruction. Surgical treatment of an ACL revision can be performed as one-stage or two-stage procedure depending on, for example, the presence of limb malalignments, concomitant injuries, and tunnel widening. Nonirradiated allografts and autologous patella tendon, hamstring tendon, and quadriceps tendon are feasible options for ACL revision. Concomitant injuries to the affected knee such as intraarticular chondral lesions are more common in the setting of an ACL revision compared with primary ACL reconstruction while a lower presence of concomitant meniscal pathology is reported at ACL revision. Patients undergoing ACL revision have lower clinical and patient-reported outcome and lower rates of return to sport when compared with primary ACL surgery cases. However, long-term follow-ups with large study cohorts evaluating outcome of ACL revision are limited. Further research is needed to confirm the present findings of this review.

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Utskriftsdatum: 2020-08-12