After 2nd ACL reconstruction, significant number of patients need subsequent procedures

Written by Eric Oliver | May 31, 2017 | Print  |

A study published in The American Journal of Sports Medicine examined subsequent surgeries after revision anterior cruciate ligament reconstruction.

David Ding, MD, of UC San Francisco, and colleagues conducted a case-controlled study of 1,205 patients who underwent revisions ACLR procedures using the Multicenter ACL Revision Study.


MARS had two-fear follow-up data for 989 patients and telephone follow-up data for 1,112 patients. Researchers collected operative reports detailing subsequent procedures if a patient reported a subsequent surgery.


Approximately 122 patients of the patients underwent a total of 172 subsequent ipsilateral knee procedures at the two-year follow-up.


Here's what you should know.


1. Concerning the reoperations procedures:

  • 27 percent were meniscal
  • 19 percent were subsequent ACLR revisions
  • 17 percent were cartilage
  • 17 percent were microfracture
  • 11 percent were hardware removal
  • 9 percent were arthrofibrosis


2. Patients under 20-years-old had twice the odds of patients between 20- and 29-years-old of undergoing a reoperation.


3. Allograft use was a significant predictor for reoperations at two years, staged revisions did not reach significance.


4. Patients with grade 4 cartilage damage during grade 4 cartilage damage observed during a revision ACLR were 78 percent less likely to need a second operation.


5. Gender, body mass index, smoking history, Marx activity score, technique for femoral tunnel placement and meniscal tearing had no effect.


Researchers concluded, "There was a significant reoperation rate after revision ACLR at two years with meniscal procedures most commonly involved."


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