Reconstruction itérative du ligament croisé antérieur par allogreffe de tendon d'Achille chez le jeune athlète

Translated title of the contribution: Anterior cruciate ligament revision with Achilles tendon allograft in young athletes

S. Zaffagnini, A. Grassi, G. M. Marcheggiani Muccioli, T. Roberti Di Sarsina, L. Macchiarola, M. Mosca, M. P. Neri, M. Marcacci

Research output: Contribution to journalArticle

Abstract

Background: Return to sport after revision ACL reconstruction is a controversial topic, Several studies reported the results of different techniques and graft in sportsman, presenting an incredibly wide range of return to the same pre-injury activity level, from 0% to 100%. The purpose of this study was to evaluate the clinical outcomes and return to sport rate in young athletes after non-anatomic double-bundle revision ACL reconstruction with Achilles allograft. Hypothesis: The present revision technique was effective in terms of stability, return to sport and functional outcomes. Material and methods: All the athletes undergone Revision ACL reconstruction with non-irradiated Achilles tendon allograft with a non-anatomical double-bundle technique were included in the study. A splitted Achilles tendon allograft was used to reproduce the anteromedial (AM) bundle using the over-the-top position, while the posterolateral (PL) bundle was reconstructed through a femoral tunnel located in the anatomical PL footprint. Sport activity, knee function with Lysholm score, knee laxity and reinjury or reoperations were evaluated. Results: Twenty-six athletes (23 males, 3 females) with a mean age of 23.4. ±. 3.6 years were evaluated at a mean follow-up of 6.0. ±. 1.6 years. Overall 69% of patients returned to sport both at elite (44%) or county level (56%) after a mean 6.7. ±. 1.5 (3-9 range) months. The mean Lysholm score showed a significant improvement from 64.4. ±. 8.1 at preoperative status to 83.8. ±. 11.3 at final follow-up (P <. .0001). Seven patients (30%) were rated as excellent, 9 (39%) as good, 5 (22%) as fair and 2 (9%) as poor. Three patients (12%) experienced a further graft rupture after a mean 2.6 years (3.5 months-48 months range) and 2 had. >. 5. mm side-to-side difference at KT-1000. Therefore, the overall survival rate at mean 6 years follow-up was 81%. Conclusion: The ACL revision with a double-bundle technique using Achilles tendon allograft was successful in 81% of athletes at 6 years mean follow-up. Type of study and level of evidence: Retrospective case series, level IV.

Translated title of the contributionAnterior cruciate ligament revision with Achilles tendon allograft in young athletes
Original languageFrench
JournalRevue de Chirurgie Orthopedique et Traumatologique
DOIs
Publication statusAccepted/In press - Jan 1 2017

Keywords

  • Achilles tendon
  • ACL reconstruction
  • Allograft
  • Return to Sport
  • Revision

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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