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Outcomes Following Single-Stage versus Two-Stage Revision Anterior Cruciate Ligament Reconstruction

      Introduction

      Revision anterior cruciate ligament reconstruction (ACLR) is becoming increasingly common as the number of primary ACLR cases continues to rise. Despite this, there is limited data discussing the outcomes of revision ACLR, and even less information addressing the differences in single stage revision reconstructions versus those performed in a two stage fashion.

      Methods

      Patients undergoing revision ACLR between 2010 and 2014 by a single surgeon were collected. Skeletally mature individuals over the age of 17 were included. Patients were excluded if they were skeletally immature, had a previous intraarticular infection in the ipsilateral knee, had prior alignment correction , cartilage repair or transplant procedure, meniscal allograft transplantation, or intraarticular fracture. Patients completed a questionnaire preoperatively and at a minimum two years postoperatively, which included the Lysholm score, Tegner activity scale, Western Ontario and McMaster Universities Arthritis Index (WOMAC), 12 item Short Form Health Survey (SF-12) Physical and Mental Component Summary (PCS/MCS), and patient satisfaction. Patient satisfaction was rated on a ten-point scale, with 1 equal to highly unsatisfied and 10 equal to highly satisfied.

      Results

      88 patients were included: 39 patients in the single-stage revision surgery group (19 males, 20 females), and 49 patients in the staged revision surgery group (27 males, 22 females). In both groups, the SF-12 PCS, WOMAC score, Lysholm score, and Tegner activity scale significantly improved preoperatively to postoperatively. There was no significant difference in the SF-12 MCS score before and after surgery in either group, and no differences in outcome scores at any time point. Furthermore, there was no significant difference in failure rates or other demographic data between groups.

      Conclusion

      Overall, objective outcomes and subjective patient scores and satisfaction were not significantly different between one-stage and two-stage ACL revision surgeries. Both procedures resulted in significantly improved outcomes and patient subjective outcomes without notable differences in failure rates.