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J Knee Surg 2020; 33(03): 223-227
DOI: 10.1055/s-0038-1677543
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Occurrence of Meniscal and Chondral Injury in Two-Stage Revision Anterior Cruciate Ligament Reconstruction: A Consecutive Case Series

Floris R. van Tol
1   Focus Clinic Orthopedic Surgery, Haaglanden Medical Center, Den Haag, Zuid-Holland, The Netherlands
,
Willem A. Kernkamp
1   Focus Clinic Orthopedic Surgery, Haaglanden Medical Center, Den Haag, Zuid-Holland, The Netherlands
,
Robert J. P. van der Wal
2   Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
,
Jan-Willem A. Swen
1   Focus Clinic Orthopedic Surgery, Haaglanden Medical Center, Den Haag, Zuid-Holland, The Netherlands
,
Samuel K. Van de Velde
1   Focus Clinic Orthopedic Surgery, Haaglanden Medical Center, Den Haag, Zuid-Holland, The Netherlands
,
Ewoud R. A. van Arkel
1   Focus Clinic Orthopedic Surgery, Haaglanden Medical Center, Den Haag, Zuid-Holland, The Netherlands
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Publikationsverlauf

03. Juli 2018

30. November 2018

Publikationsdatum:
18. Januar 2019 (online)

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Abstract

Two-stage revision anterior cruciate ligament (ACL) reconstruction is an effective way to revise suboptimal tunnel-placement allowing for proper graft fixation. However, prolonged increased laxity of the knee may increase the risk of meniscal or chondral injury. It was hypothesized that no additional meniscal or chondral lesions occur in between the two stages of the two-stage revision ACL reconstruction. In this retrospective study, 42 patients undergoing a two-stage revision ACL reconstruction were included. Surgical notes for both stages were screened for meniscal and chondral status, interventions to any concurrent injury, surgery dates, along with basic patient characteristics. In 4 of the 42 patients, a new meniscal tear occurred in between the two stages, of which three required partial meniscectomy during the second stage of the ACL revision. One patient experienced a new small degenerative tear that did not require intervention. Two out of the four menisci that were repaired during the first stage had failed and required partial meniscectomy. No significant difference was found in the time between the two stages with respect to the occurrence of meniscal tears. No significant differences in chondral status were found. In conclusion, approximately 10% of patients developed a new meniscal tear and no difference in macroscopic chondral injury was observed between the first and second stages.

Keywords

revision anterior cruciate ligament reconstruction - meniscal tears - two-stage revision - bone grafting

Authors' Contributions

Study conception and design: F.R.v.T., W.A.K., S.K.v.d.V., and E.R.A.v.A.


Acquisition of data: F.R.v.T.


Analysis and interpretation of data: F.R.v.T., W.A.K., and S.K.v.d.V.


Drafting of manuscript: F.R.v.T., W.A.K., and S.K.v.d.V.


Critical revision: W.A.K., S.K.v.d.V., R.J.P.v.d.W., J.W.A.S., and E.R.A.A.


Apporval of final version: F.R.v.T., W.A.K., S.K.v.d.V., R.J.P.v.d.W., J.W.A.S., and E.R.A.A.