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J Knee Surg 2021; 34(08): 859-863
DOI: 10.1055/s-0039-3402075
Original Article

Risk Factors for Requiring a Revision Anterior Cruciate Ligament Reconstruction: A Case—Control Study

Authors

  • Todd P. Pierce

    1   Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey

  • Jennifer Kurowicki 

    1   Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey

  • John J. Kelly

    2   Department of Orthopaedic Surgery, School of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

  • Kimona Issa

    1   Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey

  • Anthony Festa

    1   Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey
    3   Department of Orthopaedic Surgery, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey

  • Vincent K. McInerney

    1   Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey
    3   Department of Orthopaedic Surgery, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey

  • Anthony J. Scillia

    1   Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey
    3   Department of Orthopaedic Surgery, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey
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Abstract

Anterior cruciate ligament (ACL) reconstruction is considered as a successful orthopaedic procedure that attempts to help patients return to their preinjury level of activity. However, some patients may need to undergo revision surgery, and this potentially may be associated with certain surgery-specific or patient risk factors. Therefore, the purpose of this study was to assess the potential role of (1) demographics, (2) family history, (3) graft choice, (4) sport, and (5) mechanism of injury (contact vs. noncontact) in the risk for needing a revision ACL for improved clinical outcomes. All patients who had undergone a primary ACL reconstruction between 2012 and 2016 were identified from at a single institution. About 312 patients who had a mean age of 24 years (range, 9–62 years) and a mean follow-up of 4 years (range, 1–10). Patients were further evaluated to identify those who had a revision. There were 19 patients (6.1%) with a mean age of 22 years (range, 13–38 years) and a mean follow-up of 5 years (range, 1–10) that required a revision reconstruction. Gender ratios (p = 0.56) and mean age (p = 0.44) were similar among the cohorts. Family history of ACL reconstruction had no association with revision risk (p = 0.57). Those with tibialis anterior allografts (37 vs. 4%; p = 0.0001) and hamstring allografts (16 vs. 1%; p = 0.0001) were far more likely to undergo a revision. Bone-tendon-bone (BTB) patella autografts were less likely (26 vs. 73%; p = 0.0001). Sport did not play a role in revision with those injured playing basketball (p = 0.61), football (p = 0.52), lacrosse (p = 0.52), soccer (p = 0.83), and volleyball (p = 0.61). There were a greater percentage of contact injuries that required revision (95 vs. 77%; p = 0.07). Graft selection played a significant role in requiring revision surgery with allografts portending to higher revision rates and BTB patella autografts conferring a lower risk.

Keywords

ACL reconstruction - revision ACL - anterior cruciate ligament - risk factors


Publication History

Received: 18 February 2019

Accepted: 10 November 2019

Article published online:
30 December 2019

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