Risk Factors for Requiring a Revision Anterior Cruciate Ligament Reconstruction: A Case-Control Study.

Autor:	Pierce TP; Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey., Kurowicki J; Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey., Kelly JJ; Department of Orthopaedic Surgery, School of Medicine, State University of New York, Upstate Medical University, Syracuse, New York., Issa K; Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey., Festa A; Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey.; Department of Orthopaedic Surgery, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey., McInerney VK; Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey.; Department of Orthopaedic Surgery, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey., Scillia AJ; Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey.; Department of Orthopaedic Surgery, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey.
Jazyk:	angličtina
Zdroj:	The journal of knee surgery [J Knee Surg] 2021 Jul; Vol. 34 (8), pp. 859-863. Date of Electronic Publication: 2019 Dec 30.
DOI:	10.1055/s-0039-3402075
Abstrakt:	Anterior cruciate ligament (ACL) reconstruction is considered as a successful orthopaedic procedure that attempts to help patients return to their preinjury level of activity. However, some patients may need to undergo revision surgery, and this potentially may be associated with certain surgery-specific or patient risk factors. Therefore, the purpose of this study was to assess the potential role of (1) demographics, (2) family history, (3) graft choice, (4) sport, and (5) mechanism of injury (contact vs. noncontact) in the risk for needing a revision ACL for improved clinical outcomes. All patients who had undergone a primary ACL reconstruction between 2012 and 2016 were identified from at a single institution. About 312 patients who had a mean age of 24 years (range, 9-62 years) and a mean follow-up of 4 years (range, 1-10). Patients were further evaluated to identify those who had a revision. There were 19 patients (6.1%) with a mean age of 22 years (range, 13-38 years) and a mean follow-up of 5 years (range, 1-10) that required a revision reconstruction. Gender ratios ( p  = 0.56) and mean age ( p  = 0.44) were similar among the cohorts. Family history of ACL reconstruction had no association with revision risk ( p  = 0.57). Those with tibialis anterior allografts (37 vs. 4%; p  = 0.0001) and hamstring allografts (16 vs. 1%; p  = 0.0001) were far more likely to undergo a revision. Bone-tendon-bone (BTB) patella autografts were less likely (26 vs. 73%; p  = 0.0001). Sport did not play a role in revision with those injured playing basketball ( p  = 0.61), football ( p  = 0.52), lacrosse ( p  = 0.52), soccer ( p  = 0.83), and volleyball ( p  = 0.61). There were a greater percentage of contact injuries that required revision (95 vs. 77%; p  = 0.07). Graft selection played a significant role in requiring revision surgery with allografts portending to higher revision rates and BTB patella autografts conferring a lower risk. Competing Interests: A.J.S. reports grants and other from Iso-Biologics, other from Mitek, outside the submitted work. V.K.M. reports other from Topical Gear, outside the submitted work. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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