@article{ref1,
title="Inconsistent return to sport despite improved outcomes following re-revision anterior cruciate ligament reconstruction: an updated systematic review",
journal="Arthroscopy",
year="2023",
author="Olson, Conner P. and Mabrouk, Ahmed and Liechti, Daniel J. and Tollefson, Luke V. and Kennedy, Nicholas I. and LaPrade, Robert F.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: The primary objective was to systematically review the literature evaluating patient reported outcomes and return to sport following re-revision anterior cruciate ligament reconstruction (ACLR) procedures. The secondary objectives were two-fold: identify the risk factors that lead to revision ACLR failure and assess the secondary knee structure injuries after the initial revision ACLR. It was hypothesized that re-revision ACLR would result in improved post-operative outcomes, but that there would be a low return to the pre-injury level of sports activities due to concomitant knee injuries such as meniscal and chondral lesions. <br><br>METHODS: A systematic review of the literature was performed using Medline/PubMed and Cochrane. Inclusion criteria were outcomes of re-revision ACL reconstruction, minimum of two years follow-up, human studies, and English language. Excluded studies were basic science articles, epidemiological studies, editorials, surgical techniques, surveys, cadaveric, and animal studies. <br><br>RESULTS: Fifteen studies met the inclusion criteria and were considered for review. There were 6 Level III, and 9 Level IV studies that included 399 patients undergoing re-revision ACL reconstruction. Concomitant meniscal lesions at the time of re-revision ranged from 35% to 90%. The prevalence of concomitant cartilaginous lesions at the time of re-revision ranged from 13.6% to 90%. Compared to preoperative scores, patient reported outcomes overall improved after re-revision ACL reconstruction with mean preoperative Lysholm scores ranging from 38.4 to 73.15 and improved to postoperative scores ranging from 68 to 87.8. However, return to sport at pre-injury levels was inconsistent with rates ranging from 12.5-80%. <br><br>CONCLUSIONS: Re-revision ACL reconstruction was found to restore knee stability and improve functional outcomes. Despite this improvement, there was a low return to sport at pre-injury level. Functional outcomes were also inferior when compared to primary ACL reconstruction. Concomitant knee pathologies were also found to rise in prevalence compared to revision and primary ACLR cases.<p /> <p>Language: en</p>",
language="en",
issn="0749-8063",
doi="10.1016/j.arthro.2023.12.001",
url="http://dx.doi.org/10.1016/j.arthro.2023.12.001"
}