Five Year Outcome of Revision ACL Repair

Increased sports participation has resulted in more and more anterior cruciate ligament (ACL) injuries. Many athletes return to their former level of activity. This means more people are experiencing a failed ACL repair. In Australia, the number of patients needing an ACL revision has increased 100 per cent over the last 10 years.

In this study, the five- to nine-year results of a revision ACL repair are reported. All 50 patients had a first or primary ACL repair which ruptured and had to be repaired again. The second operation is called a revision reconstruction. All revisions were done using the hamstrings tendon graft method.

Results were measured in terms of pain intensity, level of sports activity, and joint laxity. X-rays were also taken and reviewed. Ten per cent (five patients) of the revision knees failed. The rest of the patients (45 total) had acceptable results at the five-year check-up.

The authors report that overall, results of revision ACL reconstructions are inferior to primary repairs. They found that damage to the surface of the joint was the biggest risk factor for a failed revision.

After the primary ACL repair failed, joint instability led to further joint damage. It is suggested that all primary ACL failures should be revised sooner than later to avoid this type of joint damage and poor outcome.