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One-stage Revision ACL reconstruction with hamstring autograft results in satisfactory outcome

DOI:10.1177/2325967117S00176
Authors:
Ritwik Kejriwal at Taranaki District Health Board
Ritwik Kejriwal
J. Buelow at Perth Orthopaedics &Sportsmed centre
J. Buelow
  • Perth Orthopaedics &Sportsmed centre
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Abstract

Objectives Revision anterior cruciate ligament (ACL) reconstruction is associated with poorer outcomes and higher rerupture rates when compared to primary ACL reconstruction. There is also a significant heterogeneity in surgical technique, number of stages, and graft options. We report a large single surgeon case series with hamstring autograft as a graft option. Methods Observational series of revision ACL reconstructions performed by the senior author between 2005 and 2015 was carried out. Chart reviews and clinic follow-ups were performed with the following recorded – re-rupture rate, radiographic grading of osteoarthritis, KT-1000 arthrometer test, IKDC outcome scores and knee range of motion. All patients underwent single bundle four-strand hamstring autograft performed in one stage with use of new tunnels in majority of the cases. Results 66 patients underwent hamstring autograft one-stage revision ACL reconstruction by Dr Jens Buelow. Chart review was carried out on all patients, and 26 (39%) were followed up in clinic and/or by phone with a mean follow up of 4.7 years. Outcomes included re-rupture rate of 4.5%, reoperation rate of 12%, mean visual analogue scale score of 7.6, mean side-to-side difference of 2.6 mm for KT-1000 arthrometer test, and mean IKDC score of 79. Of the 17 patients with radiographs, 40% had moderate osteoarthritis (grade 2 or 3) at follow-up. Conclusion Revision ACL reconstruction can result in a satisfactory outcome when performed with a hamstring autograft in one stage.
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2016 Combined Australian Knee Society and New Zealand Knee & Sport Society Meeting
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One-stage Revision ACL reconstruction with hamstring autograft results in satisfactory outcome
Ritwik Kejriwal, FRACS1, Jens Buelow, MD2
1Taranaki Base Hospital, New Plymouth, New Zealand
2Perth Orthopaedic and Sports Medicine Centre, Perth, Australia
Objectives: Revision anterior cruciate ligament (ACL) reconstruction is associated with poorer outcomes and
higher rerupture rates when compared to primary ACL reconstruction. There is also a significant heterogeneity in
surgical technique, number of stages, and graft options. We report a large single surgeon case series with
hamstring autograft as a graft option.
Methods: Observational series of revision ACL reconstructions performed by the senior author between 2005 and
2015 was carried out. Chart reviews and clinic follow-ups were performed with the following recorded – re-rupture
rate, radiographic grading of osteoarthritis, KT-1000 arthrometer test, IKDC outcome scores and knee range of
motion. All patients underwent single bundle four-strand hamstring autograft performed in one stage with use of
new tunnels in majority of the cases.
Results: 66 patients underwent hamstring autograft one-stage revision ACL reconstruction by Dr Jens Buelow.
Chart review was carried out on all patients, and 26 (39%) were followed up in clinic and/or by phone with a mean
follow up of 4.7 years. Outcomes included re-rupture rate of 4.5%, reoperation rate of 12%, mean visual analogue
scale score of 7.6, mean side-to-side difference of 2.6mm for KT-1000 arthrometer test, and mean IKDC score of
79. Of the 17 patients with radiographs, 40% had moderate osteoarthritis (grade 2 or 3) at follow-up.
Conclusion: Revision ACL reconstruction can result in a satisfactory outcome when performed with a hamstring
autograft in one stage.
The Orthopaedic Journal of Sports Medicine, 5(5)(suppl 5)
DOI: 10.1177/2325967117S00176
©The Author(s) 2017
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