Description
Purpose
The surgeons' choice of a single-stage or a two-stage procedure in revision anterior cruciate ligament reconstruction (ACLr) is based on the possibility of reuse of the tibia and femoral bone tunnels after primary ACLr.
The purpose of this study was to compare failure rates and clinical outcomes following single-stage and two-stage ACL revisions in a cohort of patients from The Danish Knee Ligament Reconstruction Registry (DKRR).
Methods
Patients identified from 2005 to 2022 with ACL revision and met the following criteria: minimum two-year follow-up, isolated ACL revision and registered single- or two-stage ACL revision. Primary outcome was ACL re-revision procedure. Secondary outcomes were knee laxity (side-to-side difference) and pivot shift (rotational stability difference - grade 0-1 or grade 2-3) evaluated at one-year follow up.
Results
1,574 ACL revisions were included in the study (1,331=single-stage and 243=two-stage). Baseline characteristics showed no difference in relation to age, gender, knee laxity, meniscus injury, cartilage damage or injury mechanism between the two groups. Significant differences were found in relation to pivot shift and type of graft. No statistical difference in two-years revision rates between single-stage group 2.79 (95%CI 2.03;3.84) and two-stage group 2.93 (95%CI 1.41;6.05) was found. No significant difference was seen in knee laxity and pivot shift between stage-groups at one-year follow up. Both groups demonstrated significant improvements from baseline to one-year follow-up.
Conclusion
The present study found that ACL revision outcomes were similar in terms of re-revision rates and knee laxity for patients managed with a single- or a two-stage surgical strategy.
