Patients who undergo repeated anterior cruciate ligament (ACL) reconstructions, or repeat revision surgery, are unlikely to return to prior activity levels despite showing basic functional improvement, according to research being presented at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting.
"We focused on 15 patients entering at least their third ACL surgery on the same knee, a rarity in the orthopedic community," noted lead author Diane Dahm, MD, orthopaedic surgeon from the Mayo Clinic. "These patients, ranging in age from 18 to 57, all demonstrated a return to basic function based on a collective increase in IKDC scores from pre-operative levels at 59 to post-operative levels at approximately 80."
The IKDC system allows patients to self-evaluate their post-surgery recovery. The focus group included 15 of the 18 known repeat revision surgery cases between 1998 and 2009, with eight males and seven females. All patients examined in this study reported improved outcomes in day-to-day function after a repeat revision surgery. However, only 27 percent had returned to their same pre-operative activity level at final follow up. Patients with grade III or IV chondral injuries or BMI greater than 28 had worse functional outcomes.
"While the small number of patients in this study is a limitation," commented Dahm, "the procedure is relatively uncommon and this is the largest to-date. Gathering information on these unique patients is an important step toward understanding how people will function after a repeat ACL surgery." No immediate post-operative complications were noted during the study.