Skip to main content
SpringerLink
Log in

Revision Anterior Cruciate Ligament

  • Chapter
Arthroscopy and Sport Injuries

  • 2099 Accesses

Abstract

The anterior cruciate ligament (ACL), of all ligaments in the human body, is the one most often ruptured, especially among the population practicing sports. The incidence of ACL rupture is 36.9–60.9 per 100,000 persons in the United States [1], where over 200,000 ACL ruptures are surgically reconstructed annually [2]. The rising number of primary ACL reconstructions, coupled with expected functional outcomes in high-functional-demand patients after ACL reconstruction, has led to an increase in revision ACL reconstructions. Key to correct anatomical reconstruction and functional outcome after primary repair is a thorough knowledge of ACL anatomy and biomechanics. High-functional-demand patients returning to sports with suboptimal knee joint function are at increased risk of recurrent ACL tear, chondral and meniscal damage, and progression of knee joint arthrosis [3, 4]. Though primary surgery does not always restore normal joint kinematics [5], improvement in joint stability and recovery of knee function [6] are seen in most patients, with good to excellent outcomes achieved in 80–90 % of cases [7–9]. Failure rates (recurrence of instability) range from 4 to 10 % [10–13], and results after revision ACL repair are decidedly lower, particularly in elite athletes [13–19]. Hence, the reasons for successful outcome after revision ACL reconstruction hinge on a full understanding of why the primary repair failed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Giannotti SM, Marshall SW, Hume PA, Bunt L (2009) Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study. J Sci Med Sport 12(6):622–627

    Article  Google Scholar 

  2. Parkkari J, Pasanen K, Mattila VM, Kannus P, Rimpela A (2008) The risk for a cruciate ligament injury of the knee in adolescents and young adults: a population-based cohort study of 46 500 people with a 9 year follow-up. Br J Sports Med 42(6):422–426

    Article  CAS  PubMed  Google Scholar 

  3. Bach BR Jr (2003) Revision anterior cruciate ligament surgery. Arthroscopy 19(Suppl 1):14–29

    Article  PubMed  Google Scholar 

  4. Mullaji AB, Marawar SV, Luthra M (2008) Tibial articular cartilage wear in varus osteoarthritic knees: correlation with anterior cruciate ligament integrity and severity of deformity. J Arthroplasty 23(1):128–135

    Article  PubMed  Google Scholar 

  5. Biau DJ, Katsahian S, Kartus J, Harilainen A, Feller JA, Sajovic M, Ejerhed L, Zaffagnini S, Ropke M, Nizard R (2009) Patellar tendon versus hamstring tendon autografts for reconstructing the anterior cruciate ligament: a meta-analysis based on individual patient data. Am J Sports Med 37(12):2470–2478

    Article  PubMed  Google Scholar 

  6. Biau DJ, Tournoux C, Katsahian S et al (2007) ACL reconstruction: a meta-analysis of functional scores. Clin Orthop Relat Res 458:180–187

    PubMed  Google Scholar 

  7. Chouteau J, Benareau I, Testa R, Fessy MH, Lerat JL, Moyen B (2008) Comparative study of knee anterior cruciate ligament reconstruction with or without fluoroscopic assistance: a prospective study of 73 cases. Arch Orthop Trauma Surg 128(9):945–950

    Article  PubMed  Google Scholar 

  8. Corry IS, Webb JM, Clingeleffer AJ, Pinczewski LA (1999) Arthroscopic reconstruction of the anterior cruciate ligament: a comparison of patellar tendon autograft and four-strand hamstring tendon autograft. Am J Sports Med 27(4):444–454

    CAS  PubMed  Google Scholar 

  9. Freedman KB, D’Amato MJ, Nedeff DD, Kaz A, Bach BR Jr (2003) Arthroscopic anterior cruciate ligament reconstruction: a meta-analysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 31(1):2–11

    PubMed  Google Scholar 

  10. Feller JA, Webster KE (2003) A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Am J Sports Med 31(4):564–573

    PubMed  Google Scholar 

  11. Liden M, Ejerhed L, Sernert N, Naxdal G, Kartus J (2007) Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction: a prospective, randomized study with a 7-year follow-up. Am J Sports Med 35(5):740–748

    Article  PubMed  Google Scholar 

  12. Carlisle JC, Parker RD, Matava MJ (2007) Technical considerations in revision anterior cruciate ligament surgery. J Knee Surg 20(4):312–322

    Article  PubMed  Google Scholar 

  13. Grossman MG, Elattrache NS, Shield CL, Glousman RE (2005) Revision anterior cruciate ligament reconstruction: three to nine year follow-up. Arthroscopy 21(4):418–423

    Article  PubMed  Google Scholar 

  14. Mayr R, Rosenberger R, Agraharam D, Smekal V, El Attal R (2012) Revision anterior cruciate ligament reconstruction: an update. Arch Orthop Trauma Surg 132:1299–1313

    Article  CAS  PubMed  Google Scholar 

  15. Denti M, Lo Vetere D, Bait C, Schonhuber H, Melegati G, Volpi P (2008) Revision anterior cruciate ligament reconstruction: causes of failure, surgical technique and clinical results. Am J Sports Med 36(10):1896–1902

    Article  PubMed  Google Scholar 

  16. Griffith TB, Allen BJ, Levy BA, Stuart MJ, Dahm DL (2013) Outcomes of repeat revision anterior cruciate ligament reconstruction. Am J Sports Med 41(6):1296–1301

    Article  PubMed  Google Scholar 

  17. Wright R, Spindler K, Huston L, Amendola A, Andrish J, Brophy R, Carey J, Cox C, Flanigan D, Jones M et al (2011) Revision ACL reconstruction outcomes: MOON cohort. J Knee Surg 24(4):289–294

    Article  PubMed Central  PubMed  Google Scholar 

  18. Wright RW, Gill CS, Chen L, Brophy RH, Matava MJ, Smith MV, Mall N (2012) Outcome of revision ACL reconstruction: a systematic review. J Bone Joint Surg Am 94:531–536

    PubMed Central  PubMed  Google Scholar 

  19. Gifstad T, Drogset JO, Viset A, Grontvedt T, Hortemo GS (2013) Inferior results after revision ACL reconstructions: a comparison with primary ACL reconstructions. Knee Surg Sports Traumatol Arthrosc 21:2011–2018

    Article  PubMed  Google Scholar 

  20. Harner CD, Irrgang JJ, Paul J, Dearwater S, Fu FH (1992) Loss of motion after anterior cruciate ligament reconstruction. Am J Sports Med 20(5):499–506

    Article  CAS  PubMed  Google Scholar 

  21. Mayr HO, Weig TG, Plitz W (2004) Arthrofibrosis following ACL reconstruction – reasons and outcome. Arch Orthop Trauma Surg 124(8):518–522

    Article  PubMed  Google Scholar 

  22. Mauro CS, Irrgang JJ, Williams BA, Harner CD (2008) Loss of extension following anterior cruciate ligament reconstruction: analysis of incidence and etiology using IKDC criteria. Arthroscopy 24(2):146–153

    Article  PubMed  Google Scholar 

  23. van Dijk RA, Saris DB, Willems JW, Fievez AW (2008) Additional surgery after anterior cruciate ligament reconstruction: can we improve technical aspects of the initial procedure? Arthroscopy 24(1):88–95

    Article  Google Scholar 

  24. Carson EW, Anisko EM, Restrepo C, Panariello RA, O’Brien SJ, Warren RF (2004) Revision anterior cruciate ligament reconstruction: etiology of failure and clinical results. J Knee Surg 17(3):127–132

    PubMed  Google Scholar 

  25. Wang C, Ao Y, Wang J, Hu Y, Cui G, Yu J (2009) Septic arthritis after arthroscopy ACL reconstruction: a retrospective analysis of incidence, presentation, treatment and cause. Arthroscopy 25(3):243–249

    Article  PubMed  Google Scholar 

  26. Sonnery-Cottet B, Archbold P, Zayni R, Bortolletto J, Thaunat M, Prost T, Padua VB, Chambat P (2011) Prevalence of septic arthritis after ACL reconstruction among professional athletes. Am J Sports Med 39(11):2371–2376

    Article  PubMed  Google Scholar 

  27. Diamantopoulos AP, Lorbach O, Paessler HH et al (2008) Anterior cruciate ligament reconstruction: results in 107 patients. Am J Sports Med 36:851–860

    Article  PubMed  Google Scholar 

  28. Salmon LJ, Pinczewski LA, Russel VJ (2006) Revision anterior cruciate ligament reconstruction with hamstring tendon autograft: 5 to 9 year follow-up. Am J Sports Med 34:1604–1614

    Article  PubMed  Google Scholar 

  29. Biau DJ, Tournoux C, Katsahian S, Schranz PJ, Nizard RS (2006) Bone patellar tendon-bone autografts versus hamstring autografts for reconstruction of anterior cruciate ligament: meta-analysis. BMJ 332(7548):995–1001

    Article  PubMed Central  PubMed  Google Scholar 

  30. Bourke HE, Salmon LJ, Waller A et al (2012) Survival of the anterior cruciate ligament graft and contralateral ACL at a minimum of 15 years. Am J Sports Med 40:1985–1992

    Article  PubMed  Google Scholar 

  31. Harner CD, Giffin JR, Dunteman RC, Annunziata CC, Friedman MJ (2001) Evaluation and treatment of recurrent instability after anterior cruciate ligament reconstruction. Instr Course Lect 50:463–474

    CAS  PubMed  Google Scholar 

  32. Trojani C, Sbihi A, Djian P, Potel JF, Hulet C, Jouve F, Bussiere C, Ehkirch FP, Burdin G, Dubrana F, Beaufils P, Franceschi JP, Chassaing V, Colombet P, Neyret P (2011) Causes of failure of ACL reconstruction and influence of meniscectomies after revision. Knee Surg Sports Traumatol Arthrosc 19(2):196–201

    Article  PubMed  Google Scholar 

  33. Johnson DL, Swenson TM, Irrgang JJ, Fu FH, Harner CD (1996) Revision anterior cruciate ligament surgery: experience from Pittsburgh. Clin Orthop Relat Res 325:100–109

    Article  PubMed  Google Scholar 

  34. O’Neill DB (2001) Arthroscopically assisted reconstruction of the anterior cruciate ligament. A follow-up report. J Bone Joint Surg Am 83-A(9):1329–1332

    PubMed  Google Scholar 

  35. Shelbourne KD, O’Shea JJ (2002) Revision anterior cruciate ligament reconstruction using the contralateral bone-patellar tendon-bone graft. Instr Course Lect 51:343–346

    PubMed  Google Scholar 

  36. Noyes FR, Barber-Westin SD (2001) Revision anterior cruciate surgery with use of bone-patellar tendon-bone autogenous grafts. J Bone Joint Surg Am 83-A(8):1131–1143

    CAS  PubMed  Google Scholar 

  37. Lind M, Menhert F, Pedersen AB (2009) The first results from the Danish ACL reconstruction registry: epidemiologic and 2 year follow-up results from 5818 knee ligament reconstructions. Knee Surg Sports Traumatol Arthrosc 17(2):117–124

    Article  PubMed  Google Scholar 

  38. Wright RW, Huston LJ, Spindler KP, Dunn WR, Haas AK, Allen CR, Cooper DE, DeBerardino TM, Lantz BB, Mann BJ, Stuart MJ (2010) Descriptive epidemiology of the Multicenter ACL Revision Study (MARS) cohort. Am J Sports Med 38(10):1979–1986

    Article  PubMed  Google Scholar 

  39. Morgan JA, Dahm D, Levy B, Stuart MJ (2012) Femoral tunnel malposition in ACL revision reconstruction. J Knee Surg 25(5):361–368

    Article  PubMed Central  PubMed  Google Scholar 

  40. Yong MA, Ying-fang AO, Jia-kuo Y, Ling-hui DAI, Zhen-xing SHAO (2013) Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery. Chin Med J 126(2):280–285

    Google Scholar 

  41. Garofalo R, Djahangiri A, Siegrist O (2006) Revision anterior cruciate ligament reconstruction with quadriceps tendon-patellar bone autograft. Arthroscopy 22(2):205–214

    Article  PubMed  Google Scholar 

  42. Taggart TF, Kumar A, Bickerstaff DR (2004) Revision anterior cruciate ligament reconstruction: a midterm patient assessment. Knee 11(1):29–36

    Article  CAS  PubMed  Google Scholar 

  43. Noyes FR, Barber-Westin SD (2006) Revision anterior cruciate surgery with using a 2 stage technique with bone grafting of the tibial tunnel. Am J Sports Med 34(4):678–680

    Article  PubMed  Google Scholar 

  44. Fanelli GC, Edson CJ, Maish DR (2001) Revision anterior cruciate ligament reconstruction: associated patholaxity, tibio-femoral malalignment, rehabilitation, and results. Am J Knee Surg 14(3):201–204

    CAS  PubMed  Google Scholar 

  45. Noyes FR, Barber SD, Simon R (1993) High tibial osteotomy and ligament reconstruction in varus angulated, anterior cruciate ligament-deficient knees. A two to seven year follow-up study. Am J Sports Med 21(1):2–12

    Article  CAS  PubMed  Google Scholar 

  46. Merchant MH Jr, Willimon SC, Vinson E, Pietrobon R, Garrett WE, Higgins LD (2010) Comparison of plain radiography, computed tomography, and magnetic resonance imaging in the evaluation of bone tunnel widening after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18(8):1059–1064

    Article  Google Scholar 

  47. Hoser C, Tecklenburg K, Kuenzel KH, Fink C (2005) Postoperative evaluation of femoral tunnel position in ACL reconstruction: plain radiography versus computed tomography. Knee Surg Sports Traumatol Arthrosc 13(4):256–262

    Article  PubMed  Google Scholar 

  48. Karns DJ, Heidt RS, Holladay BR, Colosimo AJ (1994) Case report: revision anterior cruciate ligament reconstruction. Arthroscopy 10:148–157

    Article  CAS  PubMed  Google Scholar 

  49. Kartus J, Stener S, Lindhal S, Eriksson BL, Karlsson J (1998) Ipsi- or contralateral patellar tendon graft in anterior cruciate ligament reconstruction. Am J Sports Med 26:499–504

    CAS  PubMed  Google Scholar 

  50. Carey JL, Dunn WR, Dahm DL, Zeger SL, Spindler KB (2009) A systematic review of anterior cruciate ligament reconstruction with autograft compared with allograft. J Bone Joint Surg Am 91(9):2242–2250

    Article  PubMed Central  PubMed  Google Scholar 

  51. Borchers JR, Pedroza A, Kaeding C (2009) Activity level and graft type as risk factors for anterior cruciate ligament graft failure: a case-control study. Am J Sports Med 37(12):2362–2367

    Article  PubMed  Google Scholar 

  52. Harner CD, Lo MY (2009) Future of allografts in sport medicine. Clin Sports Med 28(2):327–340

    Article  PubMed  Google Scholar 

  53. Thomas NP, Kankate R, Wandless F, Pandit H (2005) Revision anterior cruciate ligament reconstruction using a 2-stage technique with bone grafting of the tibial tunnel. Am J Sports Med 33(11):1701–1709

    Article  PubMed  Google Scholar 

  54. Ohly NE, Murray IR, Keating JF (2007) Revision anterior cruciate ligament reconstruction: timing of surgery and the incidence of meniscal tears and degenerative change. J Bone Joint Surg Br 89(8):1051–1054

    Article  CAS  PubMed  Google Scholar 

  55. Cheatham SA, Johnson DL (2013) Anticipating problems unique to revision ACL surgery. Sports Med Arthrosc Rev 21(2):129–134

    Article  Google Scholar 

  56. Silva A, Sampaio R, Pinto E (2012) ACL reconstruction: comparison between transtibial and anteromedial portal techniques. Knee Surg Sports Traumatol Arthrosc 20(5):896–903

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic, Clinic Città di Parma, Parma, Italy

    Paolo Adravanti MD & Stefano Nicoletti MD

Authors
  1. Paolo Adravanti MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stefano Nicoletti MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paolo Adravanti MD .

Editor information

Editors and Affiliations

  1. Knee Orthopedics and Sport Traumatology Unit,, Humanitas Clinical Institute IRCCS, Milan, Italy

    Piero Volpi

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Adravanti, P., Nicoletti, S. (2016). Revision Anterior Cruciate Ligament. In: Volpi, P. (eds) Arthroscopy and Sport Injuries. Springer, Cham. https://doi.org/10.1007/978-3-319-14815-1_42

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-14815-1_42

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14814-4

  • Online ISBN: 978-3-319-14815-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation