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Bob's ACL WWWBoard
Re: Part Two: ACL reconstruction in adolescents: a survivorship analysis
Posted By: SueBW
Date: Wednesday, 27 January 2010, at 7:47 a.m.
In Response To: Part Two: ACL reconstruction in adolescents: a survivorship analysis (tc)
> part two of abstract:
> 18 years) who underwent primary ACL reconstruction. All
> patients underwent transphyseal ACL reconstruction with
> Achilles tendon soft-tissue allograft using the same
> technique. Twenty-nine patients (10.5%) were excluded or
> lost to follow-up. Mean follow-up of the remaining 247
> patients was 6.3 years (range, 2-10 years). Data were
> collected from charts and telephone interviews. Failure was
> defined as the report of symptomatic knee instability
> and/or revision ACL surgery. The Kaplan-Meier method showed
> that 1-year survivorship of ACL reconstruction was 96.4%
> and 5-year survivorship was 93.1%.
The usual definition of ACL failure in the literature is a return of a positive pivot-shift (grade 2 or 3), > 5 mm of increase in anterior tibial translation on Lachman or knee arthrometer testing, OR symptomatic instability. The problem is that, in the short-term, an ACL reconstruction may fail according to objective testing, but the patient may not yet be symptomatic. Since the study is short-term (long-term studies require a minimum 10-year follow-up), the true survivorship is unknown. Most survivor studies I've seen have a 10-15-20 year follow-up. I'd have to see the article to understand why certain patients were excluded, but a follow-up rate of 90% in a large series is certainly acceptable.
SueBW
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