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Outcome After Anterior Cruciate Ligament Revision

Artikel i vetenskaplig tidskrift
Författare Alexandra Horvath
Eric Hamrin Senorski
Olof Westin
Jón Karlsson
Kristian Samuelsson
Eleonor Svantesson
Publicerad i Current Reviews in Musculoskeletal Medicine
Volym 12
Nummer/häfte 3
Sidor 397-405
ISSN 1935-973X
Publiceringsår 2019
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering
Institutionen för kliniska vetenskaper, Avdelningen för ortopedi
Sidor 397-405
Språk en
Länkar dx.doi.org/10.1007/s12178-019-09571...
Ämnesord 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
Ämneskategorier Ortopedi

Sammanfattning

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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