ACL graft re-rupture after double-bundle reconstruction: Factors that influence the intra-articular pattern of injury

Carola F. van Eck, Eric J. Kropf, James R. Romanowski, Bryson P. Lesniak, Michael J. Tranovich, C. Niek van Dijk, Freddie H. Fu

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: To determine the most common rupture patterns of previously reconstructed DB-ACL cases, seen at the time of revision surgery, and to determine the influence of age, gender, time between the initial ACL reconstruction and re-injury, tunnel angle and etiology of failure. Methods: Forty patients who presented for revision surgery after previous double-bundle ACL reconstruction were enrolled. Three orthopedic surgeons independently reviewed the arthroscopic videos and determined the rupture pattern of both the anteromedial and posterolateral grafts. The graft rupture pattern was then correlated with the previously mentioned factors. Results: The most common injury pattern seen at the time of revision ACL surgery was mid-substance AM and PL bundle rupture. Factors that influenced the rupture pattern (proximal vs. mid-substance and distal rupture vs. elongated, but in continuity) were months between ACL reconstruction and re-injury (P = 0.002), the etiology of failure (traumatic vs. atraumatic) (P = 0.025) and the measured graft tunnel angle (P = 0.048). Conclusions: The most common pattern of graft re-rupture was mid-substance AM and mid-substance PL. As the length of time from the initial DB-ACL reconstruction to revision surgery increased, the pattern of injury more closely resembled that of the native ACL. Evaluation of patients who have undergone double-bundle ACL reconstruction, with a particular focus on graft maturity, mechanism of injury and femoral tunnel angles, and graft rupture pattern assists in preoperative planning for revision surgery.

Original languageEnglish
Pages (from-to)340-346
Number of pages7
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume19
Issue number3
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

Fingerprint

Rupture
Joints
Transplants
Reoperation
Wounds and Injuries
Thigh

Keywords

  • Anterior cruciate ligament
  • Double-bundle ACL
  • Graft failure
  • Revision surgery
  • Rupture pattern

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

van Eck, C. F., Kropf, E. J., Romanowski, J. R., Lesniak, B. P., Tranovich, M. J., van Dijk, C. N., & Fu, F. H. (2011). ACL graft re-rupture after double-bundle reconstruction: Factors that influence the intra-articular pattern of injury. Knee Surgery, Sports Traumatology, Arthroscopy, 19(3), 340-346. https://doi.org/10.1007/s00167-010-1297-8

ACL graft re-rupture after double-bundle reconstruction : Factors that influence the intra-articular pattern of injury. / van Eck, Carola F.; Kropf, Eric J.; Romanowski, James R.; Lesniak, Bryson P.; Tranovich, Michael J.; van Dijk, C. Niek; Fu, Freddie H.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 19, No. 3, 01.01.2011, p. 340-346.

Research output: Contribution to journalArticle

van Eck, Carola F. ; Kropf, Eric J. ; Romanowski, James R. ; Lesniak, Bryson P. ; Tranovich, Michael J. ; van Dijk, C. Niek ; Fu, Freddie H. / ACL graft re-rupture after double-bundle reconstruction : Factors that influence the intra-articular pattern of injury. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2011 ; Vol. 19, No. 3. pp. 340-346.
@article{f806715815f54c488526836c122fc40c,
title = "ACL graft re-rupture after double-bundle reconstruction: Factors that influence the intra-articular pattern of injury",
abstract = "Purpose: To determine the most common rupture patterns of previously reconstructed DB-ACL cases, seen at the time of revision surgery, and to determine the influence of age, gender, time between the initial ACL reconstruction and re-injury, tunnel angle and etiology of failure. Methods: Forty patients who presented for revision surgery after previous double-bundle ACL reconstruction were enrolled. Three orthopedic surgeons independently reviewed the arthroscopic videos and determined the rupture pattern of both the anteromedial and posterolateral grafts. The graft rupture pattern was then correlated with the previously mentioned factors. Results: The most common injury pattern seen at the time of revision ACL surgery was mid-substance AM and PL bundle rupture. Factors that influenced the rupture pattern (proximal vs. mid-substance and distal rupture vs. elongated, but in continuity) were months between ACL reconstruction and re-injury (P = 0.002), the etiology of failure (traumatic vs. atraumatic) (P = 0.025) and the measured graft tunnel angle (P = 0.048). Conclusions: The most common pattern of graft re-rupture was mid-substance AM and mid-substance PL. As the length of time from the initial DB-ACL reconstruction to revision surgery increased, the pattern of injury more closely resembled that of the native ACL. Evaluation of patients who have undergone double-bundle ACL reconstruction, with a particular focus on graft maturity, mechanism of injury and femoral tunnel angles, and graft rupture pattern assists in preoperative planning for revision surgery.",
keywords = "Anterior cruciate ligament, Double-bundle ACL, Graft failure, Revision surgery, Rupture pattern",
author = "{van Eck}, {Carola F.} and Kropf, {Eric J.} and Romanowski, {James R.} and Lesniak, {Bryson P.} and Tranovich, {Michael J.} and {van Dijk}, {C. Niek} and Fu, {Freddie H.}",
year = "2011",
month = "1",
day = "1",
doi = "10.1007/s00167-010-1297-8",
language = "English",
volume = "19",
pages = "340--346",
journal = "Knee Surgery, Sports Traumatology, Arthroscopy",
issn = "0942-2056",
publisher = "Springer Verlag",
number = "3",

}

TY - JOUR

T1 - ACL graft re-rupture after double-bundle reconstruction

T2 - Factors that influence the intra-articular pattern of injury

AU - van Eck, Carola F.

AU - Kropf, Eric J.

AU - Romanowski, James R.

AU - Lesniak, Bryson P.

AU - Tranovich, Michael J.

AU - van Dijk, C. Niek

AU - Fu, Freddie H.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Purpose: To determine the most common rupture patterns of previously reconstructed DB-ACL cases, seen at the time of revision surgery, and to determine the influence of age, gender, time between the initial ACL reconstruction and re-injury, tunnel angle and etiology of failure. Methods: Forty patients who presented for revision surgery after previous double-bundle ACL reconstruction were enrolled. Three orthopedic surgeons independently reviewed the arthroscopic videos and determined the rupture pattern of both the anteromedial and posterolateral grafts. The graft rupture pattern was then correlated with the previously mentioned factors. Results: The most common injury pattern seen at the time of revision ACL surgery was mid-substance AM and PL bundle rupture. Factors that influenced the rupture pattern (proximal vs. mid-substance and distal rupture vs. elongated, but in continuity) were months between ACL reconstruction and re-injury (P = 0.002), the etiology of failure (traumatic vs. atraumatic) (P = 0.025) and the measured graft tunnel angle (P = 0.048). Conclusions: The most common pattern of graft re-rupture was mid-substance AM and mid-substance PL. As the length of time from the initial DB-ACL reconstruction to revision surgery increased, the pattern of injury more closely resembled that of the native ACL. Evaluation of patients who have undergone double-bundle ACL reconstruction, with a particular focus on graft maturity, mechanism of injury and femoral tunnel angles, and graft rupture pattern assists in preoperative planning for revision surgery.

AB - Purpose: To determine the most common rupture patterns of previously reconstructed DB-ACL cases, seen at the time of revision surgery, and to determine the influence of age, gender, time between the initial ACL reconstruction and re-injury, tunnel angle and etiology of failure. Methods: Forty patients who presented for revision surgery after previous double-bundle ACL reconstruction were enrolled. Three orthopedic surgeons independently reviewed the arthroscopic videos and determined the rupture pattern of both the anteromedial and posterolateral grafts. The graft rupture pattern was then correlated with the previously mentioned factors. Results: The most common injury pattern seen at the time of revision ACL surgery was mid-substance AM and PL bundle rupture. Factors that influenced the rupture pattern (proximal vs. mid-substance and distal rupture vs. elongated, but in continuity) were months between ACL reconstruction and re-injury (P = 0.002), the etiology of failure (traumatic vs. atraumatic) (P = 0.025) and the measured graft tunnel angle (P = 0.048). Conclusions: The most common pattern of graft re-rupture was mid-substance AM and mid-substance PL. As the length of time from the initial DB-ACL reconstruction to revision surgery increased, the pattern of injury more closely resembled that of the native ACL. Evaluation of patients who have undergone double-bundle ACL reconstruction, with a particular focus on graft maturity, mechanism of injury and femoral tunnel angles, and graft rupture pattern assists in preoperative planning for revision surgery.

KW - Anterior cruciate ligament

KW - Double-bundle ACL

KW - Graft failure

KW - Revision surgery

KW - Rupture pattern

UR - http://www.scopus.com/inward/record.url?scp=79951550589&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79951550589&partnerID=8YFLogxK

U2 - 10.1007/s00167-010-1297-8

DO - 10.1007/s00167-010-1297-8

M3 - Article

C2 - 21085932

AN - SCOPUS:79951550589

VL - 19

SP - 340

EP - 346

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

IS - 3

ER -