Tibial slope correction combined with second revision ACL produces good knee stability and prevents graft rupture

Verfasser / Beitragende:
[David Dejour, Mo Saffarini, Guillaume Demey, Laurent Baverel]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/10(2015-10-01), 2846-2852
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00167-015-3758-6  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-015-3758-6 
245 0 0 |a Tibial slope correction combined with second revision ACL produces good knee stability and prevents graft rupture  |h [Elektronische Daten]  |c [David Dejour, Mo Saffarini, Guillaume Demey, Laurent Baverel] 
520 3 |a Purpose: Revision ACL reconstruction requires careful analysis of failure causes particularly in cases of two previous graft ruptures. Intrinsic factors as excessive tibial slope or narrow femoral notch increase failure risks but are rarely addressed in revision surgery. The authors report outcomes, at minimum follow-up of 2years, for second revision ACL reconstructions combined with tibial deflexion osteotomy for correction of excessive slope (>12°). Methods: Nine patients that underwent second revision ACL reconstruction combined with tibial deflexion osteotomy were retrospectively studied. The mean age was 30.3±4.4years (median 28; range 26-37), and mean follow-up was 4.0±2.0years (median 3.6; range 2.0-7.6). Autografts were harvested from the quadriceps tendon (n=8) or hamstrings (n=1), and tibial osteotomy was done by anterior closing wedge, without detachment of the patellar tendon, to obtain a slope of 3° to 5°. Results: All patients had fused osteotomies, stable knees, and there were no intraoperative or postoperative complications. The mean posterior tibial slope decreased from 13.2°±2.6° (median 13°; range 12°-18°) preoperatively to 4.4°±2.3° (median 4°; range 2°-8°) postoperatively. The mean Lysholm score was 73.8±5.8 (median 74; range 65-82), and the IKDC-SKF was 71.6±6.1 (median 72.8; range 62.2-78.5). Conclusion: The satisfactory results of second revision ACL reconstruction combined with tibial deflexion osteotomy at minimum follow-up of 2years suggest that tibia slope correction protects reconstructed ACL from fatigue failure in this study. The authors stress the importance of careful analysis failure causes prior to revision ACL reconstruction, and recommend correction of tibial slope if it exceeds 12°, to reduce the risks of graft retear. Level of evidence: III. 
540 |a European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA), 2015 
690 7 |a Anterior cruciate ligament  |2 nationallicence 
690 7 |a ACL failure  |2 nationallicence 
690 7 |a ACL revision  |2 nationallicence 
690 7 |a Posterior tibial slope  |2 nationallicence 
690 7 |a Tibial closed wedge osteotomy  |2 nationallicence 
690 7 |a Tibial deflexion osteotomy  |2 nationallicence 
700 1 |a Dejour  |D David  |u Lyon-Ortho-Clinic, Clinique de la Sauvegarde, 8 Avenue Ben Gourion, 69009, Lyon, France  |4 aut 
700 1 |a Saffarini  |D Mo  |u Accelerate Innovation Management SA, 1 Rue de la Navigation, 1201, Geneva, Switzerland  |4 aut 
700 1 |a Demey  |D Guillaume  |u Lyon-Ortho-Clinic, Clinique de la Sauvegarde, 8 Avenue Ben Gourion, 69009, Lyon, France  |4 aut 
700 1 |a Baverel  |D Laurent  |u Lyon-Ortho-Clinic, Clinique de la Sauvegarde, 8 Avenue Ben Gourion, 69009, Lyon, France  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/10(2015-10-01), 2846-2852  |x 0942-2056  |q 23:10<2846  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-015-3758-6  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-015-3758-6  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Dejour  |D David  |u Lyon-Ortho-Clinic, Clinique de la Sauvegarde, 8 Avenue Ben Gourion, 69009, Lyon, France  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Saffarini  |D Mo  |u Accelerate Innovation Management SA, 1 Rue de la Navigation, 1201, Geneva, Switzerland  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Demey  |D Guillaume  |u Lyon-Ortho-Clinic, Clinique de la Sauvegarde, 8 Avenue Ben Gourion, 69009, Lyon, France  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Baverel  |D Laurent  |u Lyon-Ortho-Clinic, Clinique de la Sauvegarde, 8 Avenue Ben Gourion, 69009, Lyon, France  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/10(2015-10-01), 2846-2852  |x 0942-2056  |q 23:10<2846  |1 2015  |2 23  |o 167