title: Return-to-Sport Outcomes After Revision Anterior Cruciate Ligament Reconstruction Surgery.
abstract: BACKGROUND
  There are limited and inconsistent data regarding return-to-sport outcomes after revision anterior cruciate ligament reconstruction (ACLR).
  
  
  OBJECTIVE
  Return-to-sport rates will be lower after revision ACLR when compared with primary ACLR.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.
authors.forename: Bobby S
authors.initials: BS
authors.lastname: Anand
authors.affiliation: OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.
authors.forename: Julian A
authors.initials: JA
authors.lastname: Feller
authors.affiliation: OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.
authors.forename: Anneka K
authors.initials: AK
authors.lastname: Richmond
authors.affiliation: School of Allied Health, La Trobe University, Melbourne, Australia k.webster@latrobe.edu.au.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Webster
mesh_terms: D000328:Adult; D017677:Age Distribution; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D008297:Male; D063868:Patient Outcome Assessment; D011788:Quality of Life; D012086:Reoperation; D000068958:Return to Sport / Q000502:physiology*; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D000070600:Tibial Meniscus Injuries
keywords: ACL; reconstruction; return to sport; revision