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Return-to-Sport Outcomes After Revision Anterior Cruciate Ligament Reconstruction Surgery.
Am J Sports Med 2016; 44(3):580-4AJ

Abstract

BACKGROUND

There are limited and inconsistent data regarding return-to-sport outcomes after revision anterior cruciate ligament reconstruction (ACLR).

HYPOTHESIS

Return-to-sport rates will be lower after revision ACLR when compared with primary ACLR.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

The study cohort consisted of 136 eligible patients who had undergone their first revision ACLR between March 2006 and March 2010. Of these, 109 patients (80%) completed a sports activity survey at a mean 5-year follow-up (range, 3-7 years). Follow-up also included the International Knee Documentation Committee (IKDC) subjective form, Marx Activity Scale, and Knee injury and Osteoarthritis Outcome Score-quality of life (KOOS-QOL) form. Operative details were obtained from the clinical record.

RESULTS

After revision ACLR, 46% (95% CI, 37%-55%) of patients returned to their preinjury level of sport, compared with 50% (95% CI, 41%-59%) after the primary reconstruction in the same patients. Of the patients who were not able to return to their preinjury level of sport after primary reconstruction, 33% improved to the point that they were able to do so after revision. Younger patients were more likely to have returned to their same level of sport (58% vs 38%, P < .05), while the rate of return was the same between male and female patients. Those who returned to their preinjury level of sport scored higher Marx (P < .01), KOOS-QOL (P < .001), and IKDC scores (P < .01) than those who did not. Patients with <50% thickness articular cartilage lesions at revision surgery were more likely to have returned to their preinjury level (52% vs 31%, P < .05) and had significantly better Marx (P < .01), KOOS-QOL (P < .01), and IKDC scores (P < .01) at follow-up. The status of the menisci at the time of revision surgery was not associated with rates of return to sport, but patients with an intact medial meniscus had significantly higher KOOS-QOL (P < .05) scores at follow-up.

CONCLUSION

Return-to-sport rates of patients after revision ACLR were similar to those after their primary surgery but were still lower than the reported rates of ACLR patients who did not need revision surgery. Greater chondral pathologic abnormalities at revision surgery were associated with reduced function at follow-up.

Authors+Show Affiliations

OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.School of Allied Health, La Trobe University, Melbourne, Australia k.webster@latrobe.edu.au.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26672024

Citation

Anand, Bobby S., et al. "Return-to-Sport Outcomes After Revision Anterior Cruciate Ligament Reconstruction Surgery." The American Journal of Sports Medicine, vol. 44, no. 3, 2016, pp. 580-4.
Anand BS, Feller JA, Richmond AK, et al. Return-to-Sport Outcomes After Revision Anterior Cruciate Ligament Reconstruction Surgery. Am J Sports Med. 2016;44(3):580-4.
Anand, B. S., Feller, J. A., Richmond, A. K., & Webster, K. E. (2016). Return-to-Sport Outcomes After Revision Anterior Cruciate Ligament Reconstruction Surgery. The American Journal of Sports Medicine, 44(3), pp. 580-4. doi:10.1177/0363546515618381.
Anand BS, et al. Return-to-Sport Outcomes After Revision Anterior Cruciate Ligament Reconstruction Surgery. Am J Sports Med. 2016;44(3):580-4. PubMed PMID: 26672024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Return-to-Sport Outcomes After Revision Anterior Cruciate Ligament Reconstruction Surgery. AU - Anand,Bobby S, AU - Feller,Julian A, AU - Richmond,Anneka K, AU - Webster,Kate E, Y1 - 2015/12/15/ PY - 2015/12/17/entrez PY - 2015/12/17/pubmed PY - 2016/10/12/medline KW - ACL KW - reconstruction KW - return to sport KW - revision SP - 580 EP - 4 JF - The American journal of sports medicine JO - Am J Sports Med VL - 44 IS - 3 N2 - BACKGROUND: There are limited and inconsistent data regarding return-to-sport outcomes after revision anterior cruciate ligament reconstruction (ACLR). HYPOTHESIS: Return-to-sport rates will be lower after revision ACLR when compared with primary ACLR. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The study cohort consisted of 136 eligible patients who had undergone their first revision ACLR between March 2006 and March 2010. Of these, 109 patients (80%) completed a sports activity survey at a mean 5-year follow-up (range, 3-7 years). Follow-up also included the International Knee Documentation Committee (IKDC) subjective form, Marx Activity Scale, and Knee injury and Osteoarthritis Outcome Score-quality of life (KOOS-QOL) form. Operative details were obtained from the clinical record. RESULTS: After revision ACLR, 46% (95% CI, 37%-55%) of patients returned to their preinjury level of sport, compared with 50% (95% CI, 41%-59%) after the primary reconstruction in the same patients. Of the patients who were not able to return to their preinjury level of sport after primary reconstruction, 33% improved to the point that they were able to do so after revision. Younger patients were more likely to have returned to their same level of sport (58% vs 38%, P < .05), while the rate of return was the same between male and female patients. Those who returned to their preinjury level of sport scored higher Marx (P < .01), KOOS-QOL (P < .001), and IKDC scores (P < .01) than those who did not. Patients with <50% thickness articular cartilage lesions at revision surgery were more likely to have returned to their preinjury level (52% vs 31%, P < .05) and had significantly better Marx (P < .01), KOOS-QOL (P < .01), and IKDC scores (P < .01) at follow-up. The status of the menisci at the time of revision surgery was not associated with rates of return to sport, but patients with an intact medial meniscus had significantly higher KOOS-QOL (P < .05) scores at follow-up. CONCLUSION: Return-to-sport rates of patients after revision ACLR were similar to those after their primary surgery but were still lower than the reported rates of ACLR patients who did not need revision surgery. Greater chondral pathologic abnormalities at revision surgery were associated with reduced function at follow-up. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/26672024/Return_to_Sport_Outcomes_After_Revision_Anterior_Cruciate_Ligament_Reconstruction_Surgery_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546515618381?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -