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Preoperative medial knee instability is an underestimated risk factor for failure of revision ACL reconstruction

Standard

Preoperative medial knee instability is an underestimated risk factor for failure of revision ACL reconstruction. / Alm, Lena; Krause, Matthias; Frosch, Karl-Heinz; Akoto, Ralph.

in: KNEE SURG SPORT TR A, Jahrgang 28, Nr. 8, 08.2020, S. 2458-2467.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Alm, L, Krause, M, Frosch, K-H & Akoto, R 2020, 'Preoperative medial knee instability is an underestimated risk factor for failure of revision ACL reconstruction', KNEE SURG SPORT TR A, Jg. 28, Nr. 8, S. 2458-2467. https://doi.org/10.1007/s00167-020-06133-y

APA

Alm, L., Krause, M., Frosch, K-H., & Akoto, R. (2020). Preoperative medial knee instability is an underestimated risk factor for failure of revision ACL reconstruction. KNEE SURG SPORT TR A, 28(8), 2458-2467. https://doi.org/10.1007/s00167-020-06133-y

Vancouver

Alm L, Krause M, Frosch K-H, Akoto R. Preoperative medial knee instability is an underestimated risk factor for failure of revision ACL reconstruction. KNEE SURG SPORT TR A. 2020 Aug;28(8):2458-2467. https://doi.org/10.1007/s00167-020-06133-y

Bibtex

@article{5d2a1feac33d42a99750f1f65d6a2fe2,
title = "Preoperative medial knee instability is an underestimated risk factor for failure of revision ACL reconstruction",
abstract = "PURPOSE: The purpose of this study was to carefully analyse the reasons for revision ACLR failure to optimize the surgical revision technique and minimize the risk of recurrent re-rupture. Large studies with a minimum of 2 years of follow-up that clinically examine patients with revision ACLR are rare.METHODS: Between 2013 and 2016, 111 patients who underwent revision ACLR were included in the retrospective study. All patients were examined for a minimum of 2 years after revision surgery (35 ± 3.4 months, mean ± STD) and identified as {"}failed revision ACLR{"} (side-to-side difference ≥ 5 mm and pivot-shift grade 2/3) or {"}stable revision ACLR{"}.RESULTS: Failure after revision ACLR occurred in 14.5% (n = 16) of the cases. Preoperative medial knee instability (n = 36) was associated with failure; thus, patients had a 17 times greater risk of failure when medial knee instability was diagnosed (p = 0.015). The risk of failure was reduced when patients had medial stabilization (n = 24, p = 0.034) and extra-articular lateral tenodesis during revision surgery (n = 51, p = 0.028). Increased posterior tibial slope (n = 11 ≥ 12°, p = 0.046) and high-grade anterior knee laxity (side-to-side difference > 6 mm and pivot-shift grade 3, n = 41, p = 0.034) were associated with increased failure of revision ACLR. Obese patients had a 9 times greater risk of failure (p = 0.008, n = 30).CONCLUSION: This study demonstrates the largest revision ACLR patient group with pre- and postoperative clinical examination data and a follow-up of 2 years published to date. Preoperative medial knee instability is an underestimated risk factor for revision ACLR failure. Additionally, high-grade anterior knee laxity, increased PTS and high BMI are risk factors for failure of revision ACLR, while additional medial stabilization and lateral extra-articular tenodesis reduce the risk of failure.LEVEL OF EVIDENCE: III.",
author = "Lena Alm and Matthias Krause and Karl-Heinz Frosch and Ralph Akoto",
year = "2020",
month = aug,
doi = "10.1007/s00167-020-06133-y",
language = "English",
volume = "28",
pages = "2458--2467",
journal = "KNEE SURG SPORT TR A",
issn = "0942-2056",
publisher = "Springer",
number = "8",

}

RIS

TY - JOUR

T1 - Preoperative medial knee instability is an underestimated risk factor for failure of revision ACL reconstruction

AU - Alm, Lena

AU - Krause, Matthias

AU - Frosch, Karl-Heinz

AU - Akoto, Ralph

PY - 2020/8

Y1 - 2020/8

N2 - PURPOSE: The purpose of this study was to carefully analyse the reasons for revision ACLR failure to optimize the surgical revision technique and minimize the risk of recurrent re-rupture. Large studies with a minimum of 2 years of follow-up that clinically examine patients with revision ACLR are rare.METHODS: Between 2013 and 2016, 111 patients who underwent revision ACLR were included in the retrospective study. All patients were examined for a minimum of 2 years after revision surgery (35 ± 3.4 months, mean ± STD) and identified as "failed revision ACLR" (side-to-side difference ≥ 5 mm and pivot-shift grade 2/3) or "stable revision ACLR".RESULTS: Failure after revision ACLR occurred in 14.5% (n = 16) of the cases. Preoperative medial knee instability (n = 36) was associated with failure; thus, patients had a 17 times greater risk of failure when medial knee instability was diagnosed (p = 0.015). The risk of failure was reduced when patients had medial stabilization (n = 24, p = 0.034) and extra-articular lateral tenodesis during revision surgery (n = 51, p = 0.028). Increased posterior tibial slope (n = 11 ≥ 12°, p = 0.046) and high-grade anterior knee laxity (side-to-side difference > 6 mm and pivot-shift grade 3, n = 41, p = 0.034) were associated with increased failure of revision ACLR. Obese patients had a 9 times greater risk of failure (p = 0.008, n = 30).CONCLUSION: This study demonstrates the largest revision ACLR patient group with pre- and postoperative clinical examination data and a follow-up of 2 years published to date. Preoperative medial knee instability is an underestimated risk factor for revision ACLR failure. Additionally, high-grade anterior knee laxity, increased PTS and high BMI are risk factors for failure of revision ACLR, while additional medial stabilization and lateral extra-articular tenodesis reduce the risk of failure.LEVEL OF EVIDENCE: III.

AB - PURPOSE: The purpose of this study was to carefully analyse the reasons for revision ACLR failure to optimize the surgical revision technique and minimize the risk of recurrent re-rupture. Large studies with a minimum of 2 years of follow-up that clinically examine patients with revision ACLR are rare.METHODS: Between 2013 and 2016, 111 patients who underwent revision ACLR were included in the retrospective study. All patients were examined for a minimum of 2 years after revision surgery (35 ± 3.4 months, mean ± STD) and identified as "failed revision ACLR" (side-to-side difference ≥ 5 mm and pivot-shift grade 2/3) or "stable revision ACLR".RESULTS: Failure after revision ACLR occurred in 14.5% (n = 16) of the cases. Preoperative medial knee instability (n = 36) was associated with failure; thus, patients had a 17 times greater risk of failure when medial knee instability was diagnosed (p = 0.015). The risk of failure was reduced when patients had medial stabilization (n = 24, p = 0.034) and extra-articular lateral tenodesis during revision surgery (n = 51, p = 0.028). Increased posterior tibial slope (n = 11 ≥ 12°, p = 0.046) and high-grade anterior knee laxity (side-to-side difference > 6 mm and pivot-shift grade 3, n = 41, p = 0.034) were associated with increased failure of revision ACLR. Obese patients had a 9 times greater risk of failure (p = 0.008, n = 30).CONCLUSION: This study demonstrates the largest revision ACLR patient group with pre- and postoperative clinical examination data and a follow-up of 2 years published to date. Preoperative medial knee instability is an underestimated risk factor for revision ACLR failure. Additionally, high-grade anterior knee laxity, increased PTS and high BMI are risk factors for failure of revision ACLR, while additional medial stabilization and lateral extra-articular tenodesis reduce the risk of failure.LEVEL OF EVIDENCE: III.

U2 - 10.1007/s00167-020-06133-y

DO - 10.1007/s00167-020-06133-y

M3 - SCORING: Journal article

C2 - 32621041

VL - 28

SP - 2458

EP - 2467

JO - KNEE SURG SPORT TR A

JF - KNEE SURG SPORT TR A

SN - 0942-2056

IS - 8

ER -