Abstract
Purpose
To compare the failure rate in patients who underwent revision anterior cruciate ligament
(ACL) reconstruction alone or associated with an extra-articular procedure. Secondary
objectives were to compare ACL laxity, patient-reported outcome measures, and complication
rates in these patients and, subsequently, to compare the outcomes of patients who
underwent revision ACL reconstruction associated with anatomical anterolateral ligament
(ALL) reconstruction or lateral extra-articular tenodesis (LET)
Methods
This was a retrospective comparative study. Patients were classified into two groups,
according to whether (Group 2) or not (Group 1) an extra-articular reconstruction
was performed. Patients who underwent an extra-articular procedure were further divided
into ALL reconstruction (Group 2A) and LET (Group 2B). Baseline demographic variables,
operative data and post-operative data were evaluated.
Results
The groups with (86 patients) and without (88 patients) an associated extra-articular
reconstrcution had similar preoperative data. Group 2 had a lower failure rate (4.6%vs.14.7%;p=0.038),
better KT-1000, better pivot shift, and better Lysholm. There was no difference regarding
complications, except more lateral pain in Group 2. Regarding the groups who underwent
ALL reconstruction (41 patients) and LET (46 patients), Group 2A showed better Lysholm
scores. Both groups had similar failure rates and complications.
Conclusion
Patients who underwent revision ACL reconstruction with a laterally based augmentation
procedure had a lower failure rate than patients who underwent isolated revision ACL
reconstruction. KT-1000 and pivot shift examination were also significantly better
when a lateral augmentation was performed. Complications were similar except for an
increase in lateral pain in the augmented group. No clinically important differences
were found when comparing the LET group to the ALL group other than a statistical
improvement in the Lysholm functional scale, likely not clinically meaningful, favoring
the ALL group and an increased duration of post-operative lateral pain in the LET
group.
Keywords
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Article Info
Publication History
Accepted:
June 26,
2022
Received in revised form:
June 25,
2022
Received:
December 23,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
Authors’ contribution
CPH— designed the study, analyzed the data and wrote the manuscript. MFS—data collection, analyzed the data and wrote the manuscript. AGMS - data collection, analyzed the data and wrote the manuscript. VBCP – acquisition and analysis of data for the work TMG - acquisition and analysis of data for the work. MBB—analyzed the data and wrote the manuscript. JRP – analyzed the data and revised the study RGG— designed the study and wrote the manuscript. GLC— analyzed the data and revised the study.
All authors read and approved the final manuscript.
Ethics approval
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University of São Paulo (CAAE 45318521.7.0000.0068 / 10/06/2021)
Level of evidence: III (Retrospective comparative therapeutic trial)
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
