Top

Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

Open Access 01-03-2011 | Knee

ACL graft re-rupture after double-bundle reconstruction: factors that influence the intra-articular pattern of injury

Authors: Carola F. van Eck, Eric J. Kropf, James R. Romanowski, Bryson P. Lesniak, Michael J. Tranovich, C. Niek van Dijk, Freddie H. Fu

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2011

Abstract

Purpose

To determine the most common rupture patterns of previously reconstructed DB-ACL cases, seen at the time of revision surgery, and to determine the influence of age, gender, time between the initial ACL reconstruction and re-injury, tunnel angle and etiology of failure.

Methods

Forty patients who presented for revision surgery after previous double-bundle ACL reconstruction were enrolled. Three orthopedic surgeons independently reviewed the arthroscopic videos and determined the rupture pattern of both the anteromedial and posterolateral grafts. The graft rupture pattern was then correlated with the previously mentioned factors.

Results

The most common injury pattern seen at the time of revision ACL surgery was mid-substance AM and PL bundle rupture. Factors that influenced the rupture pattern (proximal vs. mid-substance and distal rupture vs. elongated, but in continuity) were months between ACL reconstruction and re-injury (P = 0.002), the etiology of failure (traumatic vs. atraumatic) (P = 0.025) and the measured graft tunnel angle (P = 0.048).

Conclusions

The most common pattern of graft re-rupture was mid-substance AM and mid-substance PL. As the length of time from the initial DB-ACL reconstruction to revision surgery increased, the pattern of injury more closely resembled that of the native ACL. Evaluation of patients who have undergone double-bundle ACL reconstruction, with a particular focus on graft maturity, mechanism of injury and femoral tunnel angles, and graft rupture pattern assists in preoperative planning for revision surgery.

Cohen SB, Fu FH (2007) Three-portal technique for anterior cruciate ligament reconstruction: use of a central medial portal. Arthroscopy 23:e321–e325

Hoshino Y, Nagamune K, Yagi M, Araki D, Nishimoto K, Kubo S, Minoru D, Kurosaka M, Kuroda R (2009) The effect of intra-operative knee flexion angle on determination of graft location in the anatomic double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 17:1052–1060CrossRefPubMed

Jepsen CF, Lundberg-Jensen AK, Faunoe P (2007) Does the position of the femoral tunnel affect the laxity or clinical outcome of the anterior cruciate ligament-reconstructed knee? A clinical, prospective, randomized, double-blind study. Arthroscopy 23:1326–1333CrossRefPubMed

Kaz R, Starman JS, Fu FH (2007) Anatomic double-bundle anterior cruciate ligament reconstruction revision surgery. Arthroscopy 23:1250.e1–3

Kim SJ, Jo SB, Kumar P, Oh KS (2009) Comparison of single- and double-bundle anterior cruciate ligament reconstruction using quadriceps tendon-bone autografts. Arthroscopy 25:70–77CrossRefPubMed

Mae T, Shino K, Matsumoto N, Maeda A, Nakata K, Yoneda M (2010) Graft tension during active knee extension exercise in anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 26:214–222CrossRefPubMed

Mae T, Shino K, Miyama T, Shinjo H, Ochi T, Yoshikawa H, Fujie H (2001) Single- versus two-femoral socket anterior cruciate ligament reconstruction technique: biomechanical analysis using a robotic simulator. Arthroscopy 17:708–716CrossRefPubMed

Monaco E, Labianca L, Conteduca F, De Carli A, Ferretti A (2007) Double bundle or single bundle plus extraarticular tenodesis in ACL reconstruction? A CAOS study. Knee Surg Sports Traumatol Arthrosc 15:1168–1174CrossRefPubMed

Petersen W, Zantop T (2006) Partial rupture of the anterior cruciate ligament. Arthroscopy 22:1143–1145CrossRefPubMed

10.

Radice F, Yanez R, Gutierrez V, Rosales J, Pinedo M, Coda S (2010) Comparison of magnetic resonance imaging findings in anterior cruciate ligament grafts with and without autologous platelet-derived growth factors. Arthroscopy 26:50–57CrossRefPubMed

11.

Schenck RC Jr, Kovach IS, Agarwal A, Brummett R, Ward RA, Lanctot D, Athanasiou KA (1999) Cruciate injury patterns in knee hyperextension: a cadaveric model. Arthroscopy 15:489–495CrossRefPubMed

12.

Schreiber VM, van Eck CF, Fu FH (2010) Anatomic double-bundle ACL reconstruction. Sports Med Arthrosc 18:27–32CrossRefPubMed

13.

Shen W, Forsythe B, Ingham SM, Honkamp NJ, Fu FH (2008) Application of the anatomic double-bundle reconstruction concept to revision and augmentation anterior cruciate ligament surgeries. J Bone Joint Surg Am 90 (Suppl 4):20–34

14.

Siebold R, Fu FH (2008) Assessment and augmentation of symptomatic anteromedial or posterolateral bundle tears of the anterior cruciate ligament. Arthroscopy 24:1289–1298CrossRefPubMed

15.

Steckel H, Vadala G, Davis D, Fu FH (2006) 2D and 3D 3-tesla magnetic resonance imaging of the double bundle structure in anterior cruciate ligament anatomy. Knee Surg Sports Traumatol Arthrosc 14:1151–1158

16.

Tashman S, Collon D, Anderson K, Kolowich P, Anderst W (2004) Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med 32:975–983CrossRefPubMed

17.

Toritsuka Y, Amano H, Kuwano M, Iwai T, Mae T, Ohzono K, Shino K (2009) Outcome of double-bundle ACL reconstruction using hamstring tendons. Knee Surg Sports Traumatol Arthrosc 17:456–463CrossRefPubMed

18.

van Eck CF, Lesniak BP, Schreiber VM, Fu FH (2010) Anatomic single- and double-bundle anterior cruciate ligament reconstruction flowchart. Arthroscopy 26:258–268CrossRefPubMed

19.

van Eck CF, Schreiber VM, Liu TT, Fu FH (2010) The anatomic approach to primary, revision and augmentation anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-010-1191-4

20.

Weninger P, Zifko B, Liska M, Spitaler R, Pelinka H, Hertz H (2008) Anterior cruciate ligament reconstruction using autografts and double biodegradable femoral cross-pin fixation: functional, radiographic and MRI outcome after 2-year minimum follow-up. Knee Surg Sports Traumatol Arthrosc 16:988–995

21.

Woo SL, Kanamori A, Zeminski J, Yagi M, Papageorgiou C, Fu FH (2002) The effectiveness of reconstruction of the anterior cruciate ligament with hamstrings and patellar tendon. A cadaveric study comparing anterior tibial and rotational loads. J Bone Joint Surg Am 84-A:907–914

22.

Yagi M, Kuroda R, Nagamune K, Yoshiya S, Kurosaka M (2007) Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res 454:100–107

23.

Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30:660–666PubMed

24.

Yamamoto Y, Hsu WH, Woo SL, Van Scyoc AH, Takakura Y, Debski RE (2004) Knee stability and graft function after anterior cruciate ligament reconstruction: a comparison of a lateral and an anatomical femoral tunnel placement. Am J Sports Med 32:1825–1832CrossRefPubMed

25.

Yasuda K, Ichiyama H, Kondo E, Miyatake S, Inoue M, Tanabe Y (2008) An in vivo biomechanical study on the tension-versus-knee flexion angle curves of 2 grafts in anatomic double-bundle anterior cruciate ligament reconstruction: effects of initial tension and internal tibial rotation. Arthroscopy 24:276–284

26.

Zantop T, Brucker PU, Vidal A, Zelle BA, Fu FH (2007) Intraarticular rupture pattern of the ACL. Clin Orthop Relat Res 454:48–53

Title: ACL graft re-rupture after double-bundle reconstruction: factors that influence the intra-articular pattern of injury
Authors: Carola F. van Eck
Eric J. Kropf
James R. Romanowski
Bryson P. Lesniak
Michael J. Tranovich
C. Niek van Dijk
Freddie H. Fu
Publication date: 01-03-2011
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-010-1297-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

ACL graft re-rupture after double-bundle reconstruction: factors that influence the intra-articular pattern of injury

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2011

Sonographic measurement of iliotibial band thickness: an observational study in healthy adult volunteers

Health-related quality of life after anterior cruciate ligament reconstruction

Arthroscopic treatment of symptomatic bipartite patella

Anatomic double-bundle anterior cruciate ligament reconstruction, using CT-based navigation and fiducial markers

Single-bundle patellar tendon versus non-anatomical double-bundle hamstrings ACL reconstruction: a prospective randomized study at 8-year minimum follow-up

Malalignment and cartilage lesions in the patellofemoral joint treated with autologous chondrocyte implantation