Background: Return to sport after revision ACL reconstruction is a controversial topic, several studies reported the results of different techniques and graft in sportsman, presenting an incredibly wide range of return to the same pre-injury activity level, from 0% to 100%. The purpose of this study was to evaluate the clinical outcomes and return to sport rate in young athletes after non anatomic double-bundle revision ACL reconstruction with Achilles allograft. Hypothesis: The present revision technique was effective in terms of stability, return to sport and functional outcomes. Material and methods: All the athletes undergone Revision ACL reconstruction with non-irradiated Achilles tendon allograft with a non-anatomical double-bundle technique were included in the study. A split Achilles tendon allograft was used to reproduce the anteromedial (AM) bundle using the over-the-top position, while the posterolateral (PL) bundle was reconstructed through a femoral tunnel located in the anatomical PL footprint. Sport activity, knee function with Lysholm score, knee laxity and re-injury or re-operations were evaluated. Results: Twenty-six athletes (23 males, three females) with a mean age of 23.4. ±. 3.6 years were evaluated at a mean follow-up of 6.0. ±. 1.6 years. Overall 69% of patients returned to sport both at elite (44%) or county level (56%) after a mean 6.7. ±. 1.5 (3-9 range) months. The mean Lysholm score showed a significant improvement from 64.4. ±. 8.1 at pre-operative status to 83.8. ±. 11.3 at final follow-up (P <. .0001). Seven patients (30%) were rated as excellent, nine (39%) as good, five (22%) as fair and 2 (9%) as poor. Three patients (12%) experienced a further graft rupture after a mean 2.6 years, (3.5 months-48 months range) and two had >5. mm side-to-side difference at KT-1000. Therefore, the overall survival rate at mean six years follow-up was 81%. Conclusion: The ACL revision with a double-bundle technique using Achilles tendon allograft was successful in 81% of athletes at six years mean follow-up. Type of study and level of evidence: Retrospective case series, level IV.
Zaffagnini, S., Grassi, A., Marcheggiani Muccioli, G.M., Roberti Di Sarsina, T., Macchiarola, L., Mosca, M., et al. (2018). Anterior cruciate ligament revision with Achilles tendon allograft in young athletes. ORTHOPAEDICS & TRAUMATOLOGY: SURGERY & RESEARCH, 104(2), 209-215 [10.1016/j.otsr.2017.09.015].
Anterior cruciate ligament revision with Achilles tendon allograft in young athletes
Zaffagnini, S.Supervision
;Marcheggiani Muccioli, G. M.;Roberti Di Sarsina, T.;MACCHIAROLA, LUCA;Neri, M. P.;
2018
Abstract
Background: Return to sport after revision ACL reconstruction is a controversial topic, several studies reported the results of different techniques and graft in sportsman, presenting an incredibly wide range of return to the same pre-injury activity level, from 0% to 100%. The purpose of this study was to evaluate the clinical outcomes and return to sport rate in young athletes after non anatomic double-bundle revision ACL reconstruction with Achilles allograft. Hypothesis: The present revision technique was effective in terms of stability, return to sport and functional outcomes. Material and methods: All the athletes undergone Revision ACL reconstruction with non-irradiated Achilles tendon allograft with a non-anatomical double-bundle technique were included in the study. A split Achilles tendon allograft was used to reproduce the anteromedial (AM) bundle using the over-the-top position, while the posterolateral (PL) bundle was reconstructed through a femoral tunnel located in the anatomical PL footprint. Sport activity, knee function with Lysholm score, knee laxity and re-injury or re-operations were evaluated. Results: Twenty-six athletes (23 males, three females) with a mean age of 23.4. ±. 3.6 years were evaluated at a mean follow-up of 6.0. ±. 1.6 years. Overall 69% of patients returned to sport both at elite (44%) or county level (56%) after a mean 6.7. ±. 1.5 (3-9 range) months. The mean Lysholm score showed a significant improvement from 64.4. ±. 8.1 at pre-operative status to 83.8. ±. 11.3 at final follow-up (P <. .0001). Seven patients (30%) were rated as excellent, nine (39%) as good, five (22%) as fair and 2 (9%) as poor. Three patients (12%) experienced a further graft rupture after a mean 2.6 years, (3.5 months-48 months range) and two had >5. mm side-to-side difference at KT-1000. Therefore, the overall survival rate at mean six years follow-up was 81%. Conclusion: The ACL revision with a double-bundle technique using Achilles tendon allograft was successful in 81% of athletes at six years mean follow-up. Type of study and level of evidence: Retrospective case series, level IV.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
