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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 8, 1051-1054.
doi: 10.1302/0301-620X.89B8.19000  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Revision anterior cruciate ligament reconstruction

TIMING OF SURGERY AND THE INCIDENCE OF MENISCAL TEARS AND DEGENERATIVE CHANGE

N. E. Ohly, MRCSEd, Clinical Research Fellow1; I. R. Murray, BMedSci(Hons), Medical Student1; and J. F. Keating, FRCSEd(Orth), Consultant Orthopaedic Surgeon1

1 Department of Orthopaedic Trauma, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SU, UK.

Correspondence should be sent to Mr J. F. Keating; e-mail: john.keating{at}ed.ac.uk

We reviewed 87 patients who underwent revision reconstruction of the anterior cruciate ligament. The incidence of meniscal tears and degenerative change was assessed and related to the interval between failure of the primary graft and revision reconstruction. Patients were divided into two groups: early revision surgery within six months of graft failure, and delayed revision. Degenerative change was scored using the French Society of Arthroscopy system.

There was a significantly higher incidence of articular cartilage degeneration in the delayed group (Mann-Whitney U-test, 53.2% vs 24%, p < 0.01). No patient in the early group had advanced degenerative change, compared to 9.2% of patients in the delayed group. There was no significant difference (Mann-Whitney U-test, p = 0.3) in the incidence of meniscal tears between the two groups.

We conclude that revision reconstruction should be carried out within six months of primary graft failure, in order to minimise the risk of degenerative change.




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Revision anterior cruciate ligament (ACL) reconstruction
Benedict A Rogers, et al.
J Bone Joint Surg Br Online, 15 Oct 2007 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General