Department of Orthopedic and Trauma Surgery, Orthopedics Clinic, ItalyFulltext PDF
Over the past 15 years there have been a lot of published studies about primary ACL reconstruction; however there is relatively little literature on revision ACL reconstruction. There has been several case series describing surgeons' experiences in revision reconstructive surgery, but these are generally of evidence levels III or IV. The majority of these authors concluded that revision ACL reconstruction has a worse outcome than primary ACL reconstruction. Revision ACL reconstruction has been found to be a strong predictor for a lower perceived knee-related quality of life with a significant difference in median scores between primary reconstructions and revision reconstructions (P value =0.001). Revision reconstruction has been described as a ‘salvage procedure’ and it has been suggested that significant time should be spent counseling patients and discussing their expectations prior to surgery. Despite this studies have shown that revision surgery can be comparable to those achieved in primary reconstruction, with only little less satisfactory results. This however was again only level of evidence IV, and it highlights the need for high evidence level trials involving prospective controlled trials. The Multicenter ACL Revision Study (MARS) has set out to do this. MARS intends to develop a prospective longitudinal cohort, to provide the highest level of evidence so that it can guide clinical practice on revision ACL reconstruction. A collaboration of approximately 70 surgeons intends to identify prognosis and independent predictors of poor outcomes on revision ACL reconstruction. It is clear that more high level research needs to undertaken with regards to revision ACL reconstruction and the results of the MARS could help determine the best practices for revision ACL reconstruction and hopefully improve results of this surgery in the future. In this review, there are not figures and outcomes.
Revision; ACL; Reconstruction
Bernardino S. Revision on ACL Reconstruction: Review. Clin Surg. 2019; 4: 2664..