title: Analysis of Revision Anterior Cruciate Ligament Reconstruction according to the combined injury, degenerative change, and MRI findings.
abstract: The purposes of this study were to analyze the results of revision ACL reconstruction, and to determine the effects of pre-revision combined injuries, degenerative changes, and post-revision magnetic resonance imaging (MRI) findings on clinical results. Forty patients (41 operations) were enrolled in this study. Clinical results and stabilities were evaluated. Radiological results were evaluated using Fairbank scale. For the subgroup analysis, Fairbank scale and preoperative combined injuries were used. Follow-up MRIs were also available for 31(75.6%) patients and we searched for relations between MRI findings and clinical results. Significant improvements in subjective, objective scores (p<0.0001), and stability (p<0.0001) were observed between pre-revision surgery and final follow-up results. In the subgroup analysis according to the degenerative change, the mild group achieved better clinical results than the severe group (p=0.015 and 0.035, respectively). In the subgroup analysis according to the combined injuries, no significant difference was observed between 2 groups in terms of final follow-up Lysholm and IKDC subjective scores (p=0.083 and 0.085, respectively). No relation was found between clinical or stability results and MRI findings (p=0.26~0.99). Our results show that the severities of combined injuries were not correlated with clinical results, but the severities of degenerative changes were correlated with clinical results and that results were better in the no or mildly degenerated group. We also found that MRI is helpful for evaluating revision ACL, but that no relation was found between clinical or stability results and MRI findings of the graft after revision surgery.
authors.affiliation: Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jin Hwan
authors.initials: JH
authors.lastname: Ahn
authors.forename: Yong Seuk
authors.initials: YS
authors.lastname: Lee
authors.forename: Moon Jong
authors.initials: MJ
authors.lastname: Chang
authors.forename: Hyun Seok
authors.initials: HS
authors.lastname: Yim
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000473:pathology* / Q000503:physiopathology; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D007718:Knee Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D055815:Young Adult