Revision anterior cruciate ligament reconstruction using autografts with a polyester fixation device.
Twenty-nine patients who had undergone anterior cruciate ligament (ACL) revision were evaluated retrospectively between 1992 and 2000. A similar surgical technique was used in all cases. Twenty-six patients underwent revision following failed primary and revision surgery with the ABC scaffold ligament. There were 2 failed primary semitendinosus/gracilis (STG) autografts and one failed bone patella tendon bone (BPTB) autograft. Autologous hamstring tendons (STG) were used in 26 knees, quadriceps tendon in 2 and BPTB autograft in 1 knee. The Mark I Soffix soft tissue fixation device was used in 16 patients and 13 patients underwent reconstruction with the Mark II BH (Button Hole ) Soffix. Follow up evaluation included clinical examination, KT 2000 arthrometric side to side difference (SSD) assessment, Lysholm, Tegner and IKDC scoring. The average follow up time was 50+/-22 months. The overall SSD was 1.66+/-1.5 mm, a mean Lysholm score of 87.2+/-12.5 was obtained and 22 patients had an IKDC score of nearly normal (B). In the Mark II (BH Soffix) group knees were significantly tighter than in the Mark I Soffix group (P<0.05) with a mean SSD of 1.23+/-1.3 and 2.0+/-1.6 mm, respectively. However there were no significant differences in the other measured parameters between the two fixation devices. Multiply re-operated knees tended to have lower IKDC and Lysholm scores (not statistically significant). We concluded that the technique reported in this study can restore stability to the knee following failed primary or revision ACL reconstruction and the results in the non-multiply operated knees are comparable to primary reconstruction.
Fules
Peter J
PJ
Department of Orthopaedic Surgery, Mayday University Hospital, London Road, Croydon, Surrey CR7 7YE, UK.
Madhav
Rohit T
RT
Goddard
Richard K
RK
Mowbray
Michael A S
MA
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods; D006801:Humans; D015601:Injury Severity Score; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D011091:Polyesters / Q000627:therapeutic use*; D019736:Prostheses and Implants; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D011091:Polyesters