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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2023

28-10-2023 | Revision Anterior Cruciate Ligament Reconstruction | KNEE

Satisfactory outcomes after one-stage revision anterior cruciate ligament reconstruction using rectangular tunnel technique

Authors: Shinichiro Okimura, Tomoyuki Suzuki, Yasutoshi Ikeda, Kousuke Shiwaku, Atsushi Teramoto

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2023

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Abstract

Purpose

One-stage revision anterior cruciate ligament reconstruction (ACLR) with the anatomic rectangular tunnel (RT) technique using bone–patellar tendon–bone (BTB) grafts results in anatomically precise tunnel placement and secure graft fixation. This study evaluated knee joint laxity and clinical outcomes in terms of femoral tunnel overlap. It was hypothesised that there would be no significant differences in knee joint laxity or clinical outcomes regardless of femoral tunnel overlap.

Methods

Between 2012 and 2021, a single surgeon conducted 196 one-stage revision ACLRs with the RT technique using BTB grafts. Patients were divided based on the presence of femoral tunnel overlap. Knee joint laxity was evaluated using the Lachman test, pivot shift test, and side-to-side difference measured with a KT-1000 arthrometer. Clinical outcomes were assessed using the Lysholm score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) Knee Examination Form 2000. Knee joint laxity and clinical outcomes were compared between groups after a median follow-up of 2.5 years (range 2.0–8.0).

Results

The study included 30 and 73 patients in the overlap and non-overlap groups, respectively. No significant differences were observed in the results of the Lachman test, pivot shift test, or KT-1000 arthrometer as well as in the Lysholm, KOOS, or IKDC scores between the two groups. Based on the IKDC scores, all patients were graded as normal or nearly normal.

Conclusion

One-stage revision ACLR with the RT technique using BTB grafts improved knee joint laxity and had favourable clinical outcomes regardless of femoral tunnel overlap. To achieve optimal results in one-stage revision ACLR, it is crucial to create a tunnel within the anatomical attachment area and ensure proper graft fixation and tensioning.

Level of evidence

III.
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Metadata
Title
Satisfactory outcomes after one-stage revision anterior cruciate ligament reconstruction using rectangular tunnel technique
Authors
Shinichiro Okimura
Tomoyuki Suzuki
Yasutoshi Ikeda
Kousuke Shiwaku
Atsushi Teramoto
Publication date
28-10-2023
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-023-07627-1

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