Revision anterior cruciate ligament reconstruction by double-bundle technique using multi-strand semitendinosus tendon.
OBJECTIVE
The purpose of the study was to compare the outcome of revision anterior cruciate ligament (ACL) reconstruction by the double-bundle (DB) technique using multi-strand semitendinosus tendon with that of primary reconstruction by use of the same technique.


METHODS
The study included 21 patients who underwent revision ACL reconstruction (mean follow-up, 40 months) with the semitendinosus tendon DB technique between 1995 and 2006 and 86 unilateral primary DB ACL reconstructions (mean follow-up, 33 months) between 2000 and 2004. The outcome of both groups was compared based on differences between operated and unoperated limbs and modified International Knee Documentation Committee grades. Both the overall and sports-related subjective scores were evaluated between the 2 groups.


RESULTS
The KT measurements (MEDmetric, San Diego, CA) averaged 1.7 mm (SD, 1.8 mm) in the revision group and 1.5 mm (SD, 1.6 mm) in the primary group. There was no significant difference in KT measurements between the 2 groups. The Lachman test was negative in 83% of revision cases and 87% of primary cases; the anterior drawer test was negative in 83% and 91%, respectively, and the pivot-shift test was negative in 78% and 90%, respectively. There was a tendency for a positive pivot-shift test in the revision group being higher. The Lysholm score and subjective recovery score were significantly lower in the revision group.


CONCLUSIONS
The semitendinosus tendon DB revision procedure provided range of motion and anterior stability comparable to those after primary DB surgery and a comparable return to athletic activities. However, the patients tended to have positive pivot-shift test results. The revision cases were also inferior in terms of the general evaluation of recovery of knee condition. The outcome scores were lower overall in the revision group.


METHODS
Level IV, therapeutic case series.
Department of Orthopaedic Surgery, School of Medicine, Tokyo Medical and Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan. muneta.orj@tmd.ac.jp
Takeshi
T
Muneta
Kenji
K
Hara
Young-Jin
YJ
Ju
Tomoyuki
T
Mochizuki
Toshiyuki
T
Morito
Kazuyoshi
K
Yagishita
Ichiro
I
Sekiya
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery; D050724:Fractures, Cartilage / Q000175:diagnosis; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000534:rehabilitation; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013710:Tendons / Q000601:surgery*; D013977:Tibia / Q000601:surgery; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome; D055815:Young Adult