PMID- 37515616
OWN - NLM
STAT- MEDLINE
DCOM- 20230901
LR  - 20231007
IS  - 1433-7347 (Electronic)
IS  - 0942-2056 (Linking)
VI  - 31
IP  - 10
DP  - 2023 Oct
TI  - First revision ACL reconstruction combined with tibial deflexion osteotomy 
      improves clinical scores at 2 to 7 years follow-up.
PG  - 4467-4473
LID - 10.1007/s00167-023-07493-x [doi]
AB  - PURPOSE: To report outcomes of first revision anterior cruciate ligament 
      reconstruction (ACLR) with tibial deflexion osteotomy (TDO) in patients with 
      posterior tibial slope (PTS) >10 degrees  at >2 years. METHODS: The authors studied 
      outcomes of a consecutive series of 16 patients that underwent first revision 
      ACLR with TDO, including Lysholm score, IKDC subjective and objective scores, 
      Lachman test, PTS, and signs of osteoarthritis. One woman was excluded because of 
      early signs of knee arthritis, as the first revision ACLR took place 27 years 
      following the primary ACLR. This left a final cohort of 15 patients assessed at 
      minimum follow-up of 2 years. RESULTS: The final cohort comprised 14 men and 1 
      woman aged 25.3 +/- 6.6 years (range 16-39) at first revision ACLR. At final 
      follow-up of 4.4 +/- 1.5 years (range, 2-7), PTS was corrected from 12.5 +/- 1.8 degrees  
      (range 8-15 degrees ) to 1.9 +/- 3.6 degrees  (range - 4 to 8 degrees ), and none of the knees had 
      radiographic signs of osteoarthritis. Lysholm score was 83.8+/-12.5, IKDC 
      subjective score was 80.3+/-16.2, and IKDC objective score was A in 5 (33%), and B 
      in 10 (67%). The net improvement exceeded the minimal clinically important 
      difference (MCID) in 93% of patients for the IKDC subjective score and in 80% of 
      patients for the Lysholm score. None of the knees had any retears, and only one 
      required a reoperation to re-suture a medial meniscal tear due to trauma. 
      CONCLUSION: At 2-7 years following revision ACLR combined with TDO, net 
      improvement exceeded the MCID in 93% of patients for IKDC subjective score and in 
      80% of patients for Lysholm score, with no retears or major complications. These 
      results suggest that TDO is a safe technique to protect the ACL graft and might 
      be considered as of first revision ACLR to correct excessive PTS. LEVEL OF 
      EVIDENCE: Level IV.
CI  - (c) 2023. The Author(s) under exclusive licence to European Society of Sports 
      Traumatology, Knee Surgery, Arthroscopy (ESSKA).
FAU - Dejour, David
AU  - Dejour D
AD  - Ramsay Sante, Lyon-Ortho-Clinic, Clinique de La Sauvegarde, Lyon, France.
FAU - Rozinthe, Anouk
AU  - Rozinthe A
AD  - Ramsay Sante, Lyon-Ortho-Clinic, Clinique de La Sauvegarde, Lyon, France.
FAU - Demey, Guillaume
AU  - Demey G
AD  - Ramsay Sante, Lyon-Ortho-Clinic, Clinique de La Sauvegarde, Lyon, France.
CN  - ReSurg
LA  - eng
PT  - Journal Article
DEP - 20230729
PL  - Germany
TA  - Knee Surg Sports Traumatol Arthrosc
JT  - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
JID - 9314730
SB  - IM
MH  - Male
MH  - Female
MH  - Humans
MH  - Follow-Up Studies
MH  - *Knee Injuries/surgery
MH  - Osteotomy/methods
MH  - *Anterior Cruciate Ligament Reconstruction/methods
MH  - *Osteoarthritis/surgery
MH  - *Anterior Cruciate Ligament Injuries/surgery
MH  - Knee Joint/surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - ACLR
OT  - First revision
OT  - TDO
OT  - Tibial deflexion osteotomy
FIR - van Rooij, Floris
IR  - van Rooij F
FIR - Saffarini, Mo
IR  - Saffarini M
EDAT- 2023/07/29 21:46
MHDA- 2023/09/01 06:43
CRDT- 2023/07/29 11:04
PHST- 2023/03/22 00:00 [received]
PHST- 2023/06/12 00:00 [accepted]
PHST- 2023/09/01 06:43 [medline]
PHST- 2023/07/29 21:46 [pubmed]
PHST- 2023/07/29 11:04 [entrez]
AID - 10.1007/s00167-023-07493-x [pii]
AID - 10.1007/s00167-023-07493-x [doi]
PST - ppublish
SO  - Knee Surg Sports Traumatol Arthrosc. 2023 Oct;31(10):4467-4473. doi: 
      10.1007/s00167-023-07493-x. Epub 2023 Jul 29.