ACL graft re-rupture after double-bundle reconstruction: factors that influence the intra-articular pattern of injury

Autor: James R. Romanowski, C. Niek van Dijk, Bryson P. Lesniak, Freddie H. Fu, Eric J. Kropf, Michael J. Tranovich, Carola F. van Eck
Přispěvatelé: Other Research, Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences
Rok vydání: 2010
Předmět:
Graft Rejection
Male
Video Recording
Re rupture
Cohort Studies
Arthroscopy
Recurrence
Risk Factors
Orthopedics and Sports Medicine
Anterior Cruciate Ligament
medicine.diagnostic_test
Age Factors
musculoskeletal system
Treatment Outcome
surgical procedures
operative
medicine.anatomical_structure
Rupture pattern
Female
Revision surgery
Graft failure
Adult
Reoperation
medicine.medical_specialty
Adolescent
Anterior cruciate ligament
Knee Injuries
Statistics
Nonparametric
Young Adult
Double bundle
Intra articular
Confidence Intervals
medicine
Humans
Knee
Retrospective Studies
Chi-Square Distribution
Rupture
Spontaneous
business.industry
Anterior Cruciate Ligament Injuries
Suture Techniques
Retrospective cohort study
Plastic Surgery Procedures
Surgery
Radiography
Double-bundle ACL
Orthopedic surgery
Etiology
business
Follow-Up Studies
Zdroj: Knee surgery, sports traumatology, arthroscopy, 19(3), 340-346. Springer Verlag
Knee Surgery, Sports Traumatology, Arthroscopy
ISSN: 1433-7347
0942-2056
DOI: 10.1007/s00167-010-1297-8
Popis: Purpose To determine the most common rupture patterns of previously reconstructed DB-ACL cases, seen at the time of revision surgery, and to determine the influence of age, gender, time between the initial ACL reconstruction and re-injury, tunnel angle and etiology of failure. Methods Forty patients who presented for revision surgery after previous double-bundle ACL reconstruction were enrolled. Three orthopedic surgeons independently reviewed the arthroscopic videos and determined the rupture pattern of both the anteromedial and posterolateral grafts. The graft rupture pattern was then correlated with the previously mentioned factors. Results The most common injury pattern seen at the time of revision ACL surgery was mid-substance AM and PL bundle rupture. Factors that influenced the rupture pattern (proximal vs. mid-substance and distal rupture vs. elongated, but in continuity) were months between ACL reconstruction and re-injury (P = 0.002), the etiology of failure (traumatic vs. atraumatic) (P = 0.025) and the measured graft tunnel angle (P = 0.048). Conclusions The most common pattern of graft re-rupture was mid-substance AM and mid-substance PL. As the length of time from the initial DB-ACL reconstruction to revision surgery increased, the pattern of injury more closely resembled that of the native ACL. Evaluation of patients who have undergone double-bundle ACL reconstruction, with a particular focus on graft maturity, mechanism of injury and femoral tunnel angles, and graft rupture pattern assists in preoperative planning for revision surgery.
Databáze: OpenAIRE
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