Noronha José Carlos, Oliveira João Pedro, Brito João
Portugal Football School, Portuguese Football Federation, Portugal; Trindade Hospital, Porto, Portugal.
Portugal Football School, Portuguese Football Federation, Portugal; Coimbra Hospital and University Center, Orthopaedic Department, Portugal.
Int J Surg Case Rep. 2020;68:1-3. doi: 10.1016/j.ijscr.2020.02.027. Epub 2020 Feb 19.
Despite the reasonable success of ACL reconstruction, some athletes are not able to regain the level of play they once had.
Here, we report the case of a 32-year-old male professional soccer player who sustained an ACL injury in his right knee. The patient had a history of two prior ipsilateral ACL injuries, which was reconstructed with ipsilateral hamstring autograft (first surgery) and ipsilateral patellar tendon autograft (revision surgery). Imaging examination revealed a small narrowing of the medial femoro-tibial compartment, a complete ACL rupture, partial medial meniscectomy, small cartilage lesions in the medial condyle, a 7° varus knee, an enlarged tibial tunnel, and a femoral tunnel positioned high above the intercondylar roof. A one-step re-revision surgery using a fresh-frozen, cadaveric, non-irradiated Achilles tendon allograft was planned. After surgery, physiotherapy was conducted once per day during 4 months. The patient started running at the 6 month, and returned to full training 8 months after surgery. The player returned to full competitive play 9 months after surgery and has been competing for the last 36 months at the highest level of play without any limitation, inflammation, pain, or perception of instability.
In professional sports, when re-revision ACL reconstruction is indicated and the patient expects to return to competition, surgery should not be delayed. In these cases, the usefulness of Achilles tendon allograft should be taken into consideration for re-revision ACL reconstruction.
尽管前交叉韧带（ACL）重建手术取得了一定的成功，但一些运动员仍无法恢复到曾经的比赛水平。
在此，我们报告一例32岁男性职业足球运动员，其右膝发生ACL损伤。该患者既往有两次同侧ACL损伤史，分别接受了同侧腘绳肌自体移植（首次手术）和同侧髌腱自体移植（翻修手术）。影像学检查显示内侧股胫关节间隙轻度变窄、ACL完全断裂、内侧半月板部分切除、内侧髁小面积软骨损伤、膝关节内翻7°、胫骨隧道扩大以及股骨隧道位于髁间顶上方较高位置。计划采用新鲜冷冻、未经辐照的尸体跟腱同种异体移植物进行一期再次翻修手术。术后，在4个月内每天进行一次物理治疗。患者在术后6个月开始跑步，8个月后恢复全面训练。该运动员在术后9个月恢复了全面的竞技比赛，并在过去36个月里一直在最高水平的比赛中参赛，没有任何限制、炎症、疼痛或不稳定感。
在职业体育中，当需要进行ACL再次翻修重建且患者期望重返赛场时，手术不应延迟。在这些情况下，对于ACL再次翻修重建应考虑使用跟腱同种异体移植物。
