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Double Bundle ACL Revision Reconstruction with Allograft Resulted In a Low Revision Rate At 10 Year

Double Bundle ACL Revision Reconstruction with Allograft Resulted In a Low Revision Rate At 10 Year

Luca Macchiarola, MD, ITALY Nicola Pizza, MD, ITALY Alberto Grassi, PhD, ITALY Giacomo Dal Fabbro, ITALY Stefano Zaffagnini, MD, Prof., ITALY

IRCCS Rizzoli Orthopaedic Institute, Bologna, ITALY


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Treatment / Technique

Ligaments

ACL

Diagnosis Method

MRI


Summary: Double-bundle ACL revision with fresh frozen Achilles' allograft yields satisfactory results at long-term follow-up, with an 85% overall survival rate at mean 10 years follow-up and good patient-reported clinical scores.


Purpose

This study was aimed to report the long-term second revision rate and subjective clinical outcomes from a cohort of patients who underwent a double-bundle (DB) ACLR revision with allograft at a single institution.

Methods

The Institutional database was searched according to the following inclusion criteria: (1) patients that underwent DB-ACL revision with Achille’s tendon allograft, (2) surgery performed between January 2000 and December 2012, (3) age at revision = 18 y/o. Patients’ general information, history, surgical data, and personal contacts were extracted from charts. An online survey platform was implemented to collect responses via email. The questions of the survey included: date of surgeries, surgical data, date of graft failure and subsequent second ACL revision surgery, any other surgery of the index knee, contralateral ACLR, KOOS score, Tegner scores.

Results

Eighty-one patients were included in the survival analysis, mean age at revision 32±9.2 y/o, 71 males, mean BMI 24.7±2.7, mean time from ACL to revision 6.8±5.4 years, mean follow-up time 10.7±1.4 years. Overall, there were 12 (15%) second ACL revisions during the follow-up period, three females and nine males, at a mean 4.5±3 years after the index surgery. The overall survival rates were 68% for all reoperations, 85% for a second revision. Considering only the successful procedures (61 patients), at final follow-up, the mean values for the KOOS subscales were 84±15.5 for Pain, 88.1±13.6 for Symptoms, 93±11.6 for ADL, 75±24.5 for Sport and 71±19.6 for Qol. Twenty-nine (48%) patients performed sports activity at the same level as before ACLR failure.

Conclusions

Double-bundle ACL revision with fresh frozen Achilles' allograft yields satisfactory results at long-term follow-up, with an 85% overall survival rate at mean 10 years follow-up and good patient-reported clinical scores.


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