Revision of Failed ACL Reconstruction - Early Result -

전방 십자 인대 재 재건술 단기 추시 결과

  • Ahn Jin-Hwan (Department of Orthopedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University) ;
  • Cho Yong-Jin (Department of Orthopedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University) ;
  • Lee Yong-Seuk (Department of Orthopedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University) ;
  • Shin Seong-Kee (Department of Orthopedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University)
  • 안진환 (성균관대학교 의과대학 삼성서울병원 정형외과학교실) ;
  • 조용진 (성균관대학교 의과대학 삼성서울병원 정형외과학교실) ;
  • 이용석 (성균관대학교 의과대학 삼성서울병원 정형외과학교실) ;
  • 신성기 (성균관대학교 의과대학 삼성서울병원 정형외과학교실)
  • Published : 2003.12.01

Abstract

Purpose : The purpose was to evaluate the early result of revision of failed anterior cruciate ligament (ACL) reconstruction. Materials and Methods : From August 1997 to February 2002, this report presents the findings of 18 patients who had revision surgery for failed ACL reconstruction. There was an average of 39 $(7\~120)$months from index procedure to the time of revision. Allografts were used in 14 $(78\%)$cases and autografts were used in 4 $(22\%)$cases and the revision procedures were assisted by arthroscopic technique. The majority of chief complaints were instability in 16 $(89\%)$cases. Sixteen $(89\%)$ cases had 1 previous reconstruction, 2 $(11\%)$ cases had 2. Before and after revision, patients were evaluated by Lachman test, pivot shift test, KT 2000, radiographs, Lysholm score and HSS score and subjective satisfaction. Results : Average length of followup was 27 $(12\~60)$months. Preoperatively, all cases were positive in Lachman test and pivot shift test. After revision the majority of cases were negative. Objectively improving stability was confirmed by KT 2000 and all average KT 2000 was 7.75 $(3.5\~12.5)$mm preoperatively and 2.36 $(1.0\~6.0)$mm at final followup. Lysholm score and HSS score were also improved from 72.6 $(66\~77)$ and 72.5 $(68\~78)$ preoperatively to 89.2 $(80\~92)$ and 88.2 $(81\~92)$ at final followup. Most $(89\%)$ of patients were satisfied with their results. The most common causes of failed ACL reconstruction were malposition of femoral tunnel in 11 $(61\%)$cases. Conclusion : Arthroscopic revision ACL surgery with adequate graft for failed ACL reconstruction was successful in objectively and subjectively improving stability. However, considering the most common causes of failure after ACL reconstruction were errors in surgical technique, it is important that the primary ACL reconstruction should be performed with correct surgical technique.