Download PDF
CC BY-NC-ND 4.0 · Joints 2017; 05(01): 017-020
DOI: 10.1055/s-0037-1601410
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Revision Anterior Cruciate Ligament Reconstruction with Contralateral Hamstring Tendon Grafts: 6 Years Follow-Up

Claudio Legnani
1   IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
,
Stefania Zini
2   Scuola di Specializzazione in Ortopedia e Traumatologia, Policlinico Universitario P. Giaccone, Palermo, Italy
,
Enrico Borgo
3   Sports Traumatology and Minimally Invasive Articular Surgery Center, San Siro Clinical Institute, Milan, Italy
,
Alberto Ventura
3   Sports Traumatology and Minimally Invasive Articular Surgery Center, San Siro Clinical Institute, Milan, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
05 June 2017 (online)

   Permissions and Reprints

Abstract

Purpose The purpose of this study was to retrospectively evaluate the clinical outcome of revision anterior cruciate ligament (ACL) reconstruction with contralateral hamstring tendon autografts, specifically with regard to patient satisfaction, return to preinjury activity level, and postoperative functional outcomes.

Methods Between 2004 and 2011, 23 patients underwent revision ACL reconstruction with contralateral autogenous hamstring tendon grafts and were retrospectively reviewed at an average follow-up of 6.3 years. Subjective and functional evaluations were performed. The Tegner score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and 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. Wilcoxon test was used to compare the preoperative and follow-up status. Differences with a p-value of <0.05 were considered statistically significant.

Results No major complications were reported. The mean KOOS significantly increased from a preoperative mean of 62.8 ± 8.3 to 85.8 ± 6.9 (p < 0.001). IKDC subjective score significantly improved from 29.2 ± 10.4 to 72.8 ± 5.2 (p < 0.001). The median Tegner activity score significantly improved from a preoperative mean of 6.5 (range: 4–10) to 7.5 (range: 7–10) (p < 0.001). Most of the patients increased or returned to the same activity level, with 61% of the patients returning to cutting and pivoting sports.

Conclusion The use of contralateral hamstring tendon autografts for ACL revision surgery represents a valid option following a failed primary ACL reconstruction and confirms subjective and objective clinical improvement 6 years after surgery.

Level of Evidence Level IV, therapeutic case series.

Keywords

anterior cruciate ligament - revision surgery - contralateral - hamstring tendons - return to sports
 

  • References

  • 1 Kamath GV, Redfern JC, Greis PE, Burks RT. Revision anterior cruciate ligament reconstruction. Am J Sports Med 2011; 39 (01) 199-217
    CrossrefPubMedGoogle Scholar
  • 2 Colosimo AJ, Heidt Jr RS, Traub JA, Carlonas RL. Revision anterior cruciate ligament reconstruction with a reharvested ipsilateral patellar tendon. Am J Sports Med 2001; 29 (06) 746-750
    CrossrefPubMedGoogle Scholar
  • 3 Kartus J, Stener S, Lindahl S, Eriksson BI, Karlsson J. Ipsi- or contralateral patellar tendon graft in anterior cruciate ligament revision surgery. A comparison of two methods. Am J Sports Med 1998; 26 (04) 499-504
    CrossrefPubMedGoogle Scholar
  • 4 Noyes FR, Barber-Westin SD. Revision anterior cruciate surgery with use of bone-patellar tendon-bone autogenous grafts. J Bone Joint Surg Am 2001; 83-A (08) 1131-1143
    PubMedGoogle Scholar
  • 5 Garofalo R, Djahangiri A, Siegrist O. Revision anterior cruciate ligament reconstruction with quadriceps tendon-patellar bone autograft. Arthroscopy 2006; 22 (02) 205-214
    CrossrefPubMedGoogle Scholar
  • 6 Noyes FR, Barber-Westin SD. Anterior cruciate ligament revision reconstruction: results using a quadriceps tendon-patellar bone autograft. Am J Sports Med 2006; 34 (04) 553-564
    CrossrefPubMedGoogle Scholar
  • 7 Ferretti A, Monaco E, Caperna L, Palma T, Conteduca F. Revision ACL reconstruction using contralateral hamstrings. Knee Surg Sports Traumatol Arthrosc 2013; 21 (03) 690-695
    CrossrefPubMedGoogle Scholar
  • 8 Johnson DL, Swenson TM, Irrgang JJ, Fu FH, Harner CD. Revision anterior cruciate ligament surgery: experience from Pittsburgh. Clin Orthop Relat Res 1996; 325: 100-109
    CrossrefPubMedGoogle Scholar
  • 9 Rubinstein Jr RA, Shelbourne KD, VanMeter CD, McCarroll JC, Rettig AC. Isolated autogenous bone-patellar tendon-bone graft site morbidity. Am J Sports Med 1994; 22 (03) 324-327
    CrossrefPubMedGoogle Scholar
  • 10 Giron F, Losco M, Giannini L, Buzzi R. Femoral tunnel in revision anterior cruciate ligament reconstruction. Joints 2014; 1 (03) 126-129
    PubMedGoogle Scholar
  • 11 Shelbourne KD, Benner RW, Gray T. Return to sports and subsequent injury rates after revision anterior cruciate ligament reconstruction with patellar tendon autograft. Am J Sports Med 2014; 42 (06) 1395-1400
    CrossrefPubMedGoogle Scholar
  • 12 Peterson RK, Shelton WR, Bomboy AL. Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction: A 5-year follow-up. Arthroscopy 2001; 17 (01) 9-13
    CrossrefPubMedGoogle Scholar
  • 13 MARS Group; MARS Group. Effect of graft choice on the outcome of revision anterior cruciate ligament reconstruction in the Multicenter ACL Revision Study (MARS) Cohort. Am J Sports Med 2014; 42 (10) 2301-2310
    CrossrefPubMedGoogle Scholar