2017 ISAKOS Biennial Congress ePoster #1140

 

Re-Tear Rate 1-Year After Primary Or Revision Anterior Cruciate Ligament Reconstruction In 552 Athletes

Nicolas Lefevre, MD, Paris FRANCE
Shahnaz Klouche, MD, Paris FRANCE
Guillaume Mirouse, MD, Paris FRANCE
Antoine Gerometta, MD, Paris FRANCE
Serge Herman, MD, Paris FRANCE
Yoann Bohu, MD, Paris FRANCE

Clinique du Sport, Paris, FRANCE

FDA Status Cleared

Summary

At 1 year follow-up and in a cohort of patients operated on by the same senior surgeons, 8 (1.4%) reruptures occurred during a new sports accident and 18 (3.3%) patients underwent new surgery without any significant difference between primary and revision ACL reconstructions.

Abstract

Introduction

According to the Danish register, the revision rate for primary reconstruction of the anterior cruciate ligament (ACL) is 3% at 2-year of follow-up and 4.1% at 5-year. After iterative reconstruction, the rate is 5.4% at 5 years. The data at 1-year follow-up are rarely reported. The main objective of this study was to compare in the same cohort the re-tear rate of primary and revision ACL reconstruction at 1-year of follow-up.

Material And Methods

A longitudinal prospective single-center cohort study began in 2012 including all patients operated on by four senior surgeons for an ACL tear. A retrospective case-control study based on an analysis of data collected prospectively included a consecutive series of patients, aged 18 to 50 years, athletes, with isolated total ACL rupture, primitive or iterative, and with 1 year of follow-up. Exclusion criteria were the multi-ligament injuries, posterior cruciate ligament tear and patient refusal. Two groups were formed: "G1 primary reconstruction" and "revision reconstruction". The choice of the graft (tendons hamstring, patellar or fascia lata) was conducted according to a decision algorithm. The anesthetic and analgesic protocols were standardized. The primary endpoint was the occurrence of an ACL tear on the same knee confirmed by MRI.

Results

At October 31, 2015, the cohort included 1336 patients whom 1018 reconstructions of an isolated ACL tear. Among patients meeting study criteria, 552 (86.2%) have completed all the data at 1-year follow-up, 497 (90%) primary reconstructions and 55 (10%) revision reconstructions. The series comprised 373 men and 179 women, mean age 30.2±8.4 years. 8 (1.4%) re-tears occurred during a new sports accident within 8.9±2.9 months, 7 (1.4%) in primary reconstruction group and 1 (1.8%) revision reconstruction group, p=0.8, whatever the type of transplant (p=0.90). In addition, 18 (3.3%) patients underwent new surgery on the same knee during the first year: 12 arthrolysis for a Cyclops syndrome, 2 mobilizations under general anesthesia for stiffness, 2 meniscectomy for iterative knee blockages, 1 (2/1000) debridement for infectious arthritis and 1 chondroplasty. Algodystrophy was noted in 1 patient. No significant difference was found on the occurrence of complications during the first year between the 2 groups (p=0.13).

Conclusion

At 1 year follow-up and in a cohort of patients operated on by the same senior surgeons, 8 (1.4%) reruptures occurred during a new sports accident and 18 (3.3%) patients underwent new surgery without any significant difference between primary and revision ACL reconstructions.