Abstract
PurposeTo analyse the incidence, types and risk factors for reoperation within 2 years of primary anterior cruciate ligament reconstruction (ACLR).MethodsOur clinic registry was used to identify primary ACLRs, performed from 2005 to 2015, and reoperations performed on the ipsilateral knee within 2 years at our institution. Reoperations were identified using procedural codes and analysis of medical records. A logistic regression analysis was used to evaluate risk factors for reoperation.ResultsA total of 6030 primary ACLRs were included. A total of 1112 (18.4%) reoperations performed on 1018 (16.9%) primary ACLRs were identified. The most common reoperations were screw removal (n = 282, 4.7%), meniscus procedures (n = 238, 3.9%), cyclops removal/notchplasty (n = 222, 3.7%) and reoperations due to graft rupture (n = 146, 2.4%), including revision ACLR. Age < 30 years (OR 1.57; 95% CI 1.37–1.80; P < 0.001), female gender (OR 1.33; 95% CI 1.17–1.51; P < 0.001), medial meniscus repair (OR 1.55; 95% CI 1.23–1.97; P < 0.001), lateral meniscus resection (OR 1.26; 95% CI 1.07–1.49; P = 0.005) and lateral meniscus repair (OR 1.38; 95% CI 1.03–1.85; P = 0.02) at primary ACLR were found to be risk factors for reoperation.ConclusionOne sixth of all primary ACLRs underwent reoperation due to complications or new injuries within 2 years. The most common reoperations were screw removal, meniscus procedures, cyclops removal/notchplasty and reoperations due to graft rupture, including revision ACLR. Younger age (< 30 years), female gender, medial meniscus repair and lateral meniscus resection or repair at primary ACLR were associated with an increased risk of reoperation. This study provides clinicians with important data to inform patients about the short-term reoperation rates, the most common reoperation procedures and risk factors for reoperation after primary ACLR.Level of evidenceIII.
Highlights
Anterior cruciate ligament (ACL) tears are common and are often treated with surgical reconstruction to restore joint laxity and minimise the risk of injuries to other joint structures [6, 11]
Primary ACL reconstruction (ACLR), performed from 2005 to 2015, and reoperations performed within 2 years on the ipsilateral knee were identified
Reoperations performed within 2 years of primary ACLR were identified
Summary
Anterior cruciate ligament (ACL) tears are common and are often treated with surgical reconstruction to restore joint laxity and minimise the risk of injuries to other joint structures [6, 11]. Meniscus or cartilage injuries are present, they are often addressed at the same operation [6]. Few studies have investigated the incidence, types and risk factors for reoperation after ACL reconstruction (ACLR). The most commonly studied reoperation is revision ACLR, with an incidence reported to be between 3.6 and 7% after primary ACLR [12,13,14, 18]. Other less studied reoperations are meniscus procedures, cartilage debridement or microfracture, hardware removal
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