title: One-stage revision ACL reconstruction after primary ACL double bundle reconstruction: is bone-patella tendon-bone autograft reliable?
abstract: OBJECTIVE
  The purpose of this study is to assess the results of revision anterior cruciate ligament (ACL) reconstruction after the failure of primary ACL double bundle reconstruction (ACL-DBR).
  
  
  METHODS
  Twenty-two knees in 22 patients (group R) that underwent ACL revision surgery using bone-patellar tendon-bone (BTB) autograft after the failure of primary ACL-DBR were included in this study. Intraoperative findings and postoperative knee laxity and clinical outcomes in group R were assessed. Forty-four knees in 44 patients that were age- and gender- matched with group R and underwent primary ACL reconstruction using BTB autograft were used as a control group (group P).
  
  
  RESULTS
  The incidence of medial meniscus and cartilage injury in group R was significantly higher than those in group P (p < 0.05). At final follow-up, median Lysholm score was 90.5 (64-100) in group R and 94 (59-100) in group P, respectively. Fourteen patients (63.6%) in group R and 31 patients (70.5%) in group P were able to return to previously-played sports, respectively. There were no significant differences in KT-1000 outcomes (2.0 mm in group R and 1.4 mm in group P) or pivot shift test between the two groups. The rate of subsequent ACL injury was similar in both groups.
  
  
  CONCLUSIONS
  Revision ACL reconstruction using BTB autograft after failed primary ACL-DBR provided almost compatible postoperative clinical outcomes and knee stability with primary ACL reconstruction using BTB autograft, while the incidence of medial meniscus and cartilage injury at revision surgery was higher.
  
  
  METHODS
  Retrospective comparative study, Level III.
authors.affiliation: Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, 583-0875, Japan. m2033754@med.osaka-cu.ac.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tomihara
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, 583-0875, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Taniuchi
authors.affiliation: Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, 583-0875, Japan.
authors.forename: Junsei
authors.initials: J
authors.lastname: Takigami
authors.affiliation: Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, 583-0875, Japan.
authors.forename: Changhun
authors.initials: C
authors.lastname: Han
authors.affiliation: Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, 583-0875, Japan.
authors.forename: Nagakazu
authors.initials: N
authors.lastname: Shimada
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D064592:Autografts; D050376:Bone-Patellar Tendon-Bone Grafting / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D017847:Patellar Ligament / Q000601:surgery; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: Anterior cruciate ligament; Bone–patellar tendon–bone autograft; Double bundle reconstruction; Revision