Management of the failed first revision ACL reconstruction: Clinical outcomes of non-surgical management versus second revision ACL reconstruction - 21/11/22
Gestion de l’échec de la première révision de la reconstruction du LCA : résultats cliniques de la gestion non chirurgicale par rapport à la deuxième révision de la reconstruction du LCA
, Adnan Saithna 2, Ibrahim M. Haidar 1, Johnny El Rayes 1, Abdo El Helou 1, Cédric Ngbilo 1, Charles Pioger 1, Thais Dutra Vieira 1, Graeme Hopper 1, Bertrand Sonnery-Cottet 1Résumé |
Introduction |
The optimum management strategy following failure of revision ACL reconstruction (RACLR) is not clearly defined. The literature evaluating differences in outcomes between surgical and non-surgical management is sparse. The aim of this study was to evaluate the clinical outcomes of surgical versus non-surgical management of failed first revision ACL reconstruction.
Material and method |
Patients who experienced failure of 1st RACLR were evaluated. All participants followed the same rehabilitation protocol regardless of whether they underwent non-surgical treatment or a 2nd RACLR. Follow-up comprised regular clinical review and a standardized telephone interview at the end of the study period. Patient recorded outcome measures were reported at final follow up.
Results |
Forty-one patients with a mean follow up of 104±52.7 months (40–140) were evaluated. Thirty-one underwent 2nd RACLR and 10 chose non-surgical treatment. There was a high rate of return to sport in both groups but patients undergoing 2nd RACLR had significantly better Tegner (6.35 vs. 4.8, p=0.012), Lysholm (88.5 vs. 78.3, p=0.0353), KOOS QoL (72.6 vs. 56.3, p=0.0490) and KOOS function in sports and recreation (81.4 vs. 62.5, p=0.0033). Significantly more patients undergoing 2nd RACLR achieved PASS for KOOS function in sports and recreation than those who underwent non-surgical management (74.2% vs. 30%, p=0.015). The most important predictor of failure to achieve a good/excellent Lysholm score in multivariate analysis was non-surgical management (p=0.0095).
Conclusions |
2nd RACLR and non-surgical management of failed 1st RACLR are associated with high rates of return to sport. However, 2nd RACLR is associated with better functional outcome scores. Non-surgical treatment was the only predictor of failure to achieve a good/excellent Lysholm score at final follow-up.
Le texte complet de cet article est disponible en PDF.Keywords : ACL, ACL reconstruction, Graft failure, ACL revision
Plan
Vol 108 - N° 8S
P. S238 - décembre 2022 Retour au numéro
Article précédent
- Clinical outcomes following combined ACL and anterolateral ligament reconstruction versus isolated ACL reconstruction with bone-patellar tendon-bone autograft as a gold standard: A matched-pair analysis of 2018 patients
- Charles Pioger, Lampros Gousopoulos, Graeme Hopper, Thais Dutra Vieira, Joao Pedro Campos, Abdo El Helou, Corentin Philippe, Adnan Saithna
- Risk factors for anterior cruciate ligament graft failure in professional athletes: An analysis of 342 patients with a mean follow-up of 100 months
- Graeme Hopper, Charles Pioger, Corentin Philippe, Abdo El Helou, Joao Pedro Campos, Lampros Gousopoulos, Alessandro Carrozzo, Thais Dutra Vieira, Bertrand Sonnery-Cottet
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?