Colatruglio Matthew, Flanigan David C, Long Joseph, DiBartola Alex C, Magnussen Robert A
OSU Sports Medicine Research Institute, The Ohio State University, Columbus, Ohio, USA.
Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Am J Sports Med. 2021 Mar;49(3):798-804. doi: 10.1177/0363546520923090. Epub 2020 Jul 16.
Anterior cruciate ligament reconstruction (ACLR) is a common orthopaedic sports medicine procedure, but graft failure is not uncommon and often leads to revision ACLR. Revision surgery can be performed in a 1- or 2-stage fashion.
Graft failure risk, patient-reported outcomes, and anterior knee laxity are similar after 1- and 2-stage revision ACLR.
Systematic review; Level of evidence, 4.
A systematic review of the literature was performed to evaluate patient outcomes after 1- versus 2-stage revision ACLR. A search was performed with the phrase "revision anterior cruciate ligament reconstruction" across Embase, PubMed, Scopus, and SportDiscus from the beginning of their archives through July 12, 2019.
Thirteen studies met inclusion criteria and included 524 patients: 319 patients who underwent 1-stage revision ACLR and 205 patients who underwent 2-stage revision ACLR. Two studies compared outcomes of 1- versus 2-stage revision ACLR; 4 studies reported outcomes after 2-stage revision ACLR; and the remaining 7 studies documented outcomes after 1-stage ACLR. The mean follow-up was 4.1 years. The 2 studies that compared 1- versus 2-stage ACLR reported no differences in functional, radiologic, or patient-reported outcomes or failure risk. Overall, 9 studies reported subjective International Knee Documentation Committee (IKDC) scores; 4 studies, Knee injury and Osteoarthritis Outcome Score values; 8 studies, Lysholm scores; and 7 studies, Tegner scores; 8 studies measured anterior laxity with a KT-1000 arthrometer. The mean weighted subjective IKDC score for all studies including this outcome at final follow-up was 66.6 for 1-stage revisions and 65.9 for 2-stage revisions.
The available evidence comparing 1- versus 2-stage revision ACLR is retrospective and limited. The results of each approach are similar in appropriately selected patients.
前交叉韧带重建术（ACLR）是一种常见的骨科运动医学手术，但移植物失败并不罕见，且常常导致前交叉韧带重建翻修术。翻修手术可以分一期或二期进行。
一期和二期前交叉韧带重建翻修术后，移植物失败风险、患者报告的结局以及膝关节前侧松弛度相似。
系统评价；证据等级，4级。
进行文献系统评价，以评估一期与二期前交叉韧带重建翻修术后的患者结局。在Embase、PubMed、Scopus和SportDiscus数据库中，从建库之初至2019年7月12日，使用“前交叉韧带重建翻修术”一词进行检索。
13项研究符合纳入标准，共纳入524例患者：319例行一期前交叉韧带重建翻修术，205例行二期前交叉韧带重建翻修术。2项研究比较了一期与二期前交叉韧带重建翻修术的结局；4项研究报告了二期前交叉韧带重建翻修术后的结局；其余7项研究记录了一期前交叉韧带重建术后的结局。平均随访时间为4.1年。比较一期与二期前交叉韧带重建翻修术的2项研究报告，在功能、影像学或患者报告的结局以及失败风险方面无差异。总体而言，9项研究报告了主观国际膝关节文献委员会（IKDC）评分；4项研究报告了膝关节损伤和骨关节炎结局评分值；8项研究报告了Lysholm评分；7项研究报告了Tegner评分；8项研究使用KT-1000关节测角仪测量了前侧松弛度。在最终随访时，所有纳入该结局的研究中，一期翻修术的平均加权主观IKDC评分为66.6，二期翻修术为65.9。
比较一期与二期前交叉韧带重建翻修术的现有证据是回顾性的且有限。在适当选择的患者中，两种方法的结果相似。
