Failure Rates and Complications with Multiple-Revision ACL Reconstruction: Don’t Forget the Over-The-Top Technique

Özbek E. A.

American Orthopaedic Society For Sports Medicine, Washington, Amerika Birleşik Devletleri, 13 - 16 Temmuz 2023, cilt.1, sa.1, ss.1-2

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 1
  • Doi Numarası: 10.1177/2325967123s00302
  • Basıldığı Şehir: Washington
  • Basıldığı Ülke: Amerika Birleşik Devletleri
  • Sayfa Sayıları: ss.1-2
  • Ankara Üniversitesi Adresli: Evet

Özet

Objectives:Multiple‐revisionanteriorcruciateligamentreconstruction(ACL‐R)presentsseveraltechnicalchallenges,oftenduetoresidualhardware,tunnelwidening,ormalposition.Theaimofthisstudywastocomparecomplicationratesbetweenover‐the‐top(OTT)andanteromedialportaldrilling(AMD)techniquesinpatientsundergoingmultiple‐revisionACL‐R.Methods:Aretrospectivecohortstudycomprisedofpatientsundergoingmultiple‐revisionACL‐Rwasperformedbyfoursportsmedicinefellowshiptrainedsurgeonsinasingleinstitute.PatientswithtwoormorerevisionACL‐RsperformedwiththeOTTorAMDtechniqueswereincluded.Dataonpatientdemographics,graftcharacteristics,numberofrevisions,concomitantprocedures,complications(arthrofibrosis,septicarthritis,cyclopslesion),andfailureswerecollected.Between‐ groupcomparisonsofcontinuousandcategoricalvariableswereconductedwithindependentsamplest‐ testsandFisher’sexactorthechi‐squaredtest,respectively.Levelofsignificancewassetatp<0.05.Results:Atotalof101patientsundergoingmultiplerevisionACL‐RwithOTT(n=37,37%)andAMD(n=64,63%)techniqueswereidentified.Themeanfollow‐upperiodwas60months(range:12‐196).Nostatisticallysignificantdifferenceswerefoundinage,gender,bodymassindex,laterality,orfollow‐uplength(p>0.05,Table1)betweenthegroups.Allograftwasthemostfrequentlyusedgraft(n=64,67.3%)withnosignificantdifferencesbetweengroupsintermsofgraftdiameter.Therewerenostatisticallysignificantdifferencesbetweengroupsregardingrateofconcurrentmedialmeniscus,lateralmeniscus,cartilage,orlateralextra‐articulartenodesisprocedures(p>0.05;Table2).AsdisplayedinTable3,therewasalsonostatisticallysignificantdifferenceincomplicationrate(OTT:n=2(5.4%);AMD:n=8(13%);p>0.05)orgraftfailurerate(OTT:n=4(11%);AMD:n=14(22%);p>0.05)betweengroups.Conclusions:Theresultsofthisstudyshowednotablyelevatedfailureandcomplicationratesinchallengingmultiple‐revisionACL‐R.ComplicationandfailurerateswerelowerintheOTTcomparedtotheAMDtechnique,however,therewerenosignificantbetweengroupdifferencesintheseoutcomes.Inthesettingofmultiple‐revisionACL‐R,surgeonsmayconsidertheuseoftheOTTtechnique.