Uchida Ryohei, Toritsuka Yukiyoshi, Matsuo Tomohiko, Kusano Masashi, Tsuda Takayuki, Ando Wataru
Department of Orthopaedic Sports Medicine, Kansai Rosai Hospital, Amagasaki, Japan.
Department of Health and Sports Sciences, Mukogawa Women's University, Nishinomiya, Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2025 Sep 3;42:21-27. doi: 10.1016/j.asmart.2025.08.008. eCollection 2025 Oct.
Revision anterior cruciate ligament reconstruction (ACLR) procedures are performed either as 1-stage or 2-stage surgeries. But there has been no report of comparison in postoperative knee stability between 1-stage and 2-stage Revision ACLR. Therefore, the present study aimed to compare postoperative anterior stability after 1-stage and 2-stage surgeries.
Objective anterior knee laxity was evaluated by knee arthrometer at 12+ months postoperatively among 35 patients who underwent revision ACLR.
19 patients (Group 1: nine males and 10 females, mean age 26.4 ± 11.0 years) underwent 1-stage revision ACLR and 16 patients (12 males and four females, mean age 32.3 ± 10.6 years) underwent 2-stage revision ACLR with staged revision ACLR at six months after iliac bone grafting for large bone defects. At the final follow-up period (23 ± 9 months after 1-stage surgery and 21 ± 9 months after 2-stage surgery), procedures in two patients (10.5 %) after 1-stage surgery and one patient (6.7 %) after 2-stage surgery were found to have failed. KT side-to-side differences in anterior laxity at manual maximum force were 0.9 ± 1.1 mm and 0.9 ± 1.3 mm after 1- and 2-stage surgeries, respectively, with 94 % of patients after 1-stage surgery and 80 % of patients after 2-stage surgery showing anterior laxity values between -1 and 2 mm. We found no significant technique-dependent difference in objective anterior knee laxity between 1-stage and 2-stage revision ACLR.
After a minimum of 12 months of follow-up, patients who underwent 1-stage and 2-stage revision ACLR acquired sufficient knee stability regardless of surgical technique, showing no other significant differences.
翻修前交叉韧带重建（ACLR）手术可作为一期手术或二期手术进行。但目前尚无关于一期和二期翻修ACLR术后膝关节稳定性比较的报道。因此，本研究旨在比较一期和二期手术后的前向稳定性。
对35例行翻修ACLR手术的患者，在术后12个月以上使用膝关节测角仪评估膝关节前向松弛度。
19例患者（第1组：9例男性和10例女性，平均年龄26.4±11.0岁）接受了一期翻修ACLR手术，16例患者（12例男性和4例女性，平均年龄32.3±10.6岁）接受了二期翻修ACLR手术，对于大的骨缺损，在髂骨移植后6个月进行分期翻修ACLR手术。在最终随访期（一期手术后23±9个月，二期手术后21±9个月），发现一期手术后2例患者（10.5%）和二期手术后1例患者（6.7%）的手术失败。一期和二期手术后，手动最大力时前向松弛度的KT侧方差异分别为0.9±1.1mm和0.9±1.3mm，一期手术后94%的患者和二期手术后80%的患者前向松弛度值在-1至2mm之间。我们发现一期和二期翻修ACLR手术在客观膝关节前向松弛度方面没有显著的技术依赖性差异。
经过至少12个月的随访，接受一期和二期翻修ACLR手术的患者无论手术技术如何均获得了足够的膝关节稳定性，未显示出其他显著差异。
