Effects of revisional ACL surgery in semi-professional athletes in "high-risk pivoting sports" with chronic anterior instability of the knee.

This is a retrospective study of semi-professional athletes in "high-risk pivoting sports" after repetitive injuries of the anterior cruciate ligament (ACL) with chronic anterior instability of the knee. Effects of revisional ACL surgery on the progression of osteoarthritis, sport capacity, and knee pain were observed. Twenty-four patients, with an average age of 25.5 years, were examined on average 36.9 months postoperatively. Compared with the preoperative findings we noted a significant increase in the Lysholm and the Tegner activity score (P < 0.001). Sixteen patients (67%) were able to continue their sporting career; 17 patients (71%) were completely satisfied with the operative result. Nevertheless, 15 patients (63%) complained of persistent pain caused by sport activity. According to the Fairbank scale, 15 patients (63%) showed an increase in osteoarthritic signs between the preoperative and follow-up roentgenograms. Furthermore, there was a highly significant correlation (P < 0.001) between progression of osteoarthritis and continuous sport activity. We conclude that, after stabilization with a "bone-tendon-bone" autograft, athletes have a good chance to return to their sport. In most patients, the knee pain persisted and progression of osteoarthritis was detected. In individuals who play sport continuously, we recommend an annual follow-up with clinical examination and roentgenographic or magnetic resonance imaging examinations.