In:
Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 11, No. 7 ( 2023-07-01)
Abstract:
Multiple-revision anterior cruciate ligament reconstruction (ACLR) presents several technical challenges, often due to residual hardware, tunnel widening, malposition, or staged surgeries. Purpose: To compare failure and complication rates between the over-the-top (OTT) and transportal drilling (TD) techniques in patients undergoing surgery for failed revision ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: The medical records of patients with at least 2 revision ACLRs using either the OTT or TD technique were reviewed retrospectively. Data on patient demographics, graft characteristics, number of revisions, concomitant procedures, complications, and failures were collected. Between-group comparisons of continuous and categorical variables were conducted with the independent-samples t test and the Fisher exact or chi-square test, respectively. Results: A total of 101 patients undergoing multiple-revision ACLR with OTT (n = 37, 37%) and TD (n = 64, 63%) techniques were included for analysis. The mean follow-up time was 60 months (range, 12-196 months). There were no significant differences in age, sex, body mass index, laterality, or follow-up length between groups ( P 〉 .05). Allograft was the graft used most frequently (n = 64; 67.3%) with no significant differences between groups in graft diameter ( P 〉 .05). There were no statistically significant differences between groups regarding rate of concurrent medial and lateral meniscus, cartilage, or lateral extra-articular procedures ( P 〉 .05). There was also no significant66 between-group difference in complication rate (OTT: n = 2 [5.4%]; TD: n = 8 [13%] ) or graft failure rate (OTT: n = 4 [11%]; TD: n = 14 [22%] ) ( P 〉 .05 for both). Conclusion: The results of this study showed notably high failure and complication rates in challenging multiple-revision ACLR. Complication and failure rates were similar between techniques, demonstrating that the OTT technique is a valuable alternative that can be used in a revision ACLR, particularly as a single-stage approach when the single-stage TD technique is not possible.
Type of Medium:
Online Resource
ISSN:
2325-9671
,
2325-9671
DOI:
10.1177/23259671231186972
Language:
English
Publisher:
SAGE Publications
Publication Date:
2023
detail.hit.zdb_id:
2706251-X
SSG:
31
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