title: Can graft choice affect return to sport following revision anterior cruciate ligament reconstruction surgery?
abstract: BACKGROUND
  With the increasing number of primary anterior cruciate ligament (ACL) reconstructions, revision surgery has become more frequent. The purpose of the present study is to retrospectively compare the clinical outcome of contralateral hamstring tendon autografts vs. allografts for ACL revision surgery, specifically with regard to patient satisfaction, return to preinjury activity level, and postoperative functional outcomes.
  
  
  METHODS
  Between 2004 and 2011, 59 patients underwent ACL revision surgery. 44 were successfully recontacted and retrospectively reviewed at an average follow-up of 5.2 years. 23 subjects underwent revision ACL reconstruction with contralateral autogenous hamstring tendon grafts; 21 underwent allograft revision ACL surgery. Clinical, arthrometric, and functional evaluations were performed. The Tegner, Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) Subjective Knee Form were used. Objective evaluation included range of motion, Lachman test, pivot-shift test and KT-1000 instrumented laxity testing.
  
  
  RESULTS
  No major complications were reported. Follow-up examination showed that there were no significant differences IKDC and KOOS scores between the groups. The percentage of patients returning to pre-injury level was high in both groups. Anterior tibial translation according to manual laxity testing and as measured with KT-1000 arthrometer was not statistically different in the two groups. With regard to return to sports, patients undergoing revision surgery with autografts experienced a quicker return to sports compared to patients who underwent allograft revision surgery.
  
  
  CONCLUSIONS
  The use of contralateral hamstring tendon autografts for ACL revision surgery produced similar subjective and objective outcomes at 5.2 years follow-up compared to revision with allograft patellar or Achilles tendon. Patients undergoing revision surgery with autografts experienced a quicker return to sports compared to patients who underwent allograft revision surgery.
authors.affiliation: Minimally Invasive Articular Surgery Unit, Istituto Ortopedico G. Pini, Milan, Italy. clegnan@alice.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Legnani
authors.affiliation: Scuola di Specializzazione in Ortopedia e Traumatologia, Policlinico universitario P. Giaccone, Palermo, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Zini
authors.affiliation: Minimally Invasive Articular Surgery Unit, Istituto Ortopedico G. Pini, Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Borgo
authors.affiliation: Minimally Invasive Articular Surgery Unit, Istituto Ortopedico G. Pini, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ventura
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D000068958:Return to Sport; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
keywords: ACL revision surgery; Allograft; Anterior cruciate ligament; Return to sports