Abstract : PURPOSE The purpose of the study was to compare the outcome of revision anterior cruciate ligament
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Abstract : PURPOSE The purpose of the study was to compare the outcome of revision anterior cruciate ligament (ACL) reconstruction by the double-bundle (DB) technique using multi-strand semitendinosus tendon with that of primary reconstruction by use of the same technique.|METHODS The study included 21 patients who underwent revision ACL reconstruction (mean follow-up 40 months) with the semitendinosus tendon DB technique between 1995 and 2006 and 86 unilateral primary DB ACL reconstructions (mean follow-up 33 months) between 2000 and 2004. The outcome of both groups was compared based on differences between operated and unoperated limbs and modified International Knee Documentation Committee grades. Both the overall and sports-related subjective scores were evaluated between the 2 groups.|RESULTS The KT measurements (MEDmetric San Diego CA) averaged 1.7 mm (SD 1.8 mm) in the revision group and 1.5 mm (SD 1.6 mm) in the primary group. There was no significant difference in KT measurements between the 2 groups. The Lachman test was negative in 83 of revision cases and 87 of primary cases the anterior drawer test was negative in 83 and 91 respectively and the pivot-shift test was negative in 78 and 90 respectively. There was a tendency for a positive pivot-shift test in the revision group being higher. The Lysholm score and subjective recovery score were significantly lower in the revision group.|CONCLUSIONS The semitendinosus tendon DB revision procedure provided range of motion and anterior stability comparable to those after primary DB surgery and a comparable return to athletic activities. However the patients tended to have positive pivot-shift test results. The revision cases were also inferior in terms of the general evaluation of recovery of knee condition. The outcome scores were lower overall in the revision group.|LEVEL OF EVIDENCE: Level IV, therapeutic case series.|
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