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Descriptive Characteristics and Outcomes of Patients Undergoing Revision Anterior Cruciate Ligament Reconstruction With and Without Tunnel Bone Grafting.
DeFroda, Steven F; Owens, Brett D; Wright, Rick W; Huston, Laura J; Pennings, Jacquelyn S; Haas, Amanda K; Allen, Christina R; Cooper, Daniel E; DeBerardino, Thomas M; Dunn, Warren R; Lantz, Brett Brick A; Spindler, Kurt P; Stuart, Michael J; Albright, John P; Amendola, Annunziato Ned; Annunziata, Christopher C; Arciero, Robert A; Bach, Bernard R; Baker, Champ L; Bartolozzi, Arthur R; Baumgarten, Keith M; Bechler, Jeffery R; Berg, Jeffrey H; Bernas, Geoffrey A; Brockmeier, Stephen F; Brophy, Robert H; Bush-Joseph, Charles A; Butler, J Brad; Carey, James L; Carpenter, James E; Cole, Brian J; Cooper, Jonathan M; Cox, Charles L; Creighton, R Alexander; David, Tal S; Flanigan, David C; Frederick, Robert W; Ganley, Theodore J; Garofoli, Elizabeth A; Gatt, Charles J; Gecha, Steven R; Giffin, James Robert; Hame, Sharon L; Hannafin, Jo A; Harner, Christopher D; Harris, Norman Lindsay; Hechtman, Keith S; Hershman, Elliott B; Hoellrich, Rudolf G; Johnson, David C.
Afiliação
  • DeFroda SF; University of Missouri, Columbia, Missouri, USA.
  • Owens BD; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Wright RW; Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Huston LJ; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Pennings JS; Vanderbilt University, Nashville, Tennessee, USA.
  • Haas AK; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Allen CR; Vanderbilt University, Nashville, Tennessee, USA.
  • Cooper DE; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • DeBerardino TM; Vanderbilt University, Nashville, Tennessee, USA.
  • Dunn WR; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Lantz BBA; Washington University in St Louis, St Louis, Missouri, USA.
  • Spindler KP; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Stuart MJ; Yale University, New Haven, Connecticut, USA.
  • Albright JP; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Amendola AN; W.B. Carrell Memorial Clinic, Dallas, Texas, USA.
  • Annunziata CC; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Arciero RA; The San Antonio Orthopaedic Group, San Antonio, Texas, USA.
  • Bach BR; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Baker CL; Texas Orthopedic Hospital, Houston, Texas, USA.
  • Bartolozzi AR; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Baumgarten KM; Slocum Research & Education Foundation, Eugene, Oregon, USA.
  • Bechler JR; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Berg JH; Cleveland Clinic, Cleveland, Ohio, USA.
  • Bernas GA; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Brockmeier SF; Mayo Clinic, Rochester, Minnesota, USA.
  • Brophy RH; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Bush-Joseph CA; University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
  • Butler JB; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Carey JL; Duke University, Durham, North Carolina, USA.
  • Carpenter JE; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Cole BJ; Commonwealth Orthopaedics & Rehabilitation, Arlington, Virginia, USA.
  • Cooper JM; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Cox CL; University of Connecticut Health Center, Farmington, Connecticut, USA.
  • Creighton RA; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • David TS; Rush University Medical Center, Chicago, Illinois, USA.
  • Flanigan DC; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Frederick RW; The Hughston Clinic, Columbus, Georgia, USA.
  • Ganley TJ; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Garofoli EA; 3B Orthopaedics, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
  • Gatt CJ; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Gecha SR; Orthopedic Institute, Sioux Falls, South Dakota, USA.
  • Giffin JR; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Hame SL; University Orthopaedic Associates LLC, Princeton, New Jersey, USA.
  • Hannafin JA; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Harner CD; Town Center Orthopaedic Associates, Reston, Virginia, USA.
  • Harris NL; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Hechtman KS; State University of New York at Buffalo, Buffalo, New York, USA.
  • Hershman EB; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
  • Hoellrich RG; University of Virginia, Charlottesville, Virginia, USA.
  • Johnson DC; Investigation performed at the Department of Orthopaedics, Brown Alpert Medical School, Providence, Rhode Island, USA.
Am J Sports Med ; 50(9): 2397-2409, 2022 07.
Article em En | MEDLINE | ID: mdl-35833922
ABSTRACT

BACKGROUND:

Lytic or malpositioned tunnels may require bone grafting during revision anterior cruciate ligament reconstruction (rACLR) surgery. Patient characteristics and effects of grafting on outcomes after rACLR are not well described.

PURPOSE:

To describe preoperative characteristics, intraoperative findings, and 2-year outcomes for patients with rACLR undergoing bone grafting procedures compared with patients with rACLR without grafting. STUDY

DESIGN:

Cohort study; Level of evidence, 3.

METHODS:

A total of 1234 patients who underwent rACLR were prospectively enrolled between 2006 and 2011. Baseline revision and 2-year characteristics, surgical technique, pathology, treatment, and patient-reported outcome instruments (International Knee Documentation Committee [IKDC], Knee injury and Osteoarthritis Outcome Score [KOOS], Western Ontario and McMaster Universities Osteoarthritis Index, and Marx Activity Rating Scale [Marx]) were collected, as well as subsequent surgery information, if applicable. The chi-square and analysis of variance tests were used to compare group characteristics.

RESULTS:

A total of 159 patients (13%) underwent tunnel grafting-64 (5%) patients underwent 1-stage and 95 (8%) underwent 2-stage grafting. Grafting was isolated to the femur in 31 (2.5%) patients, the tibia in 40 (3%) patients, and combined in 88 patients (7%). Baseline KOOS Quality of Life (QoL) and Marx activity scores were significantly lower in the 2-stage group compared with the no bone grafting group (P≤ .001). Patients who required 2-stage grafting had more previous ACLRs (P < .001) and were less likely to have received a bone-patellar tendon-bone or a soft tissue autograft at primary ACLR procedure (P≤ .021) compared with the no bone grafting group. For current rACLR, patients undergoing either 1-stage or 2-stage bone grafting were more likely to receive a bone-patellar tendon-bone allograft (P≤ .008) and less likely to receive a soft tissue autograft (P≤ .003) compared with the no bone grafting group. At 2-year follow-up of 1052 (85%) patients, we found inferior outcomes in the 2-stage bone grafting group (IKDC score = 68; KOOS QoL score = 44; KOOS Sport/Recreation score = 65; and Marx activity score = 3) compared with the no bone grafting group (IKDC score = 77; KOOS QoL score = 63; KOOS Sport/Recreation score = 75; and Marx activity score = 7) (P≤ .01). The 1-stage bone graft group did not significantly differ compared with the no bone grafting group.

CONCLUSION:

Tunnel bone grafting was performed in 13% of our rACLR cohort, with 8% undergoing 2-stage surgery. Patients treated with 2-stage grafting had inferior baseline and 2-year patient-reported outcomes and activity levels compared with patients not undergoing bone grafting. Patients treated with 1-stage grafting had similar baseline and 2-year patient-reported outcomes and activity levels compared with patients not undergoing bone grafting.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Osteoartrite / Reconstrução do Ligamento Cruzado Anterior / Lesões do Ligamento Cruzado Anterior Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Osteoartrite / Reconstrução do Ligamento Cruzado Anterior / Lesões do Ligamento Cruzado Anterior Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article