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Reoperation Rates for Revision ACL Reconstruction Patients at 2 Year Follow Up


Rick W. Wright, MD
UNITED STATES

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Reoperation Rates for Revision ACL Reconstruction Patients at 2 Year Follow Up

Rick W. Wright, MD, UNITED STATES Amanda Haas, MA, UNITED STATES Laura J. Huston, MS, UNITED STATES Warren R. Dunn, MD, MPH, UNITED STATES Mars Group, MD, UNITED STATES

Washington University, Saint Louis, MO, USA

2013 Congress   Paper Abstract   2013 Congress   Not yet rated

 

Patient Populations

Pediatric / Adolescent

Anatomic Location

Knee

Anatomic Structure

Ligaments Meniscus

Diagnosis / Condition

Instability

Sports Medicine

Epidemiology Outcome Studies

Treatment / Technique

Arthroscopy Repair / Reconstruction

Ligaments

ACL

Summary: Revision ACL reconstruction results in a significant reoperation rate of 17% as noted in the MARS prospective cohort.

Introduction

Revision ACL reconstruction results in worse patient based outcomes than primary ACL reconstruction. A contributor to these outcomes may be frequent re-operation following reconstruction.

Methods

The MARS (Multicenter ACL Revision Study) group is an 83 surgeon at 52 centers prospective longitudinal cohort evaluating the results of revision ACL reconstruction. Patients are followed up at two years to obtain patient based outcome measures including reoperation rates.

Results

Follow-up was obtained on 695 of 874 eligible patients (79.5%). 118 patients (17%) underwent reoperation within 2 years of their revision reconstruction. 15 patients underwent more than one additional surgery. Procedures performed included: 35 ACL reconstructions (15 revisions, 20 contralateral primary), 6 HTOs, and 5 TKAs. 21 patients underwent hardware removal (18 Tibia, 6 Femur, 1 Patella). 41 patients underwent cartilage procedures including 45 chondroplasties, 8 microfractures, 2 chondrocyte implantations, 3 osteochondral allografts, and 1 osteochondral autograft. 57 patients underwent meniscal procedures including 48 resections, 13 repairs, and 2 allograft transplants. 24 patients underwent arthroscopic scar debridement and/or manipulation. 14 patients underwent loose body removal, 4 1 and D for infection, and 2 underwent ORIF of a patella fracture.

Conclusion

Revision ACL reconstruction results in a high reoperation rate following the index revision procedure. Many of these reoperations are substantial procedures including meniscal and osteochondral allografts, HTOs, and revisions. This high reoperation rate may contribute to the worse outcomes noted in revision reconstructions compared to primary reconstructions.