ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Management of anterior cruciate ligament revision in adults: the 2022 ESSKA consensus part III-indications for different clinical scenarios using the RAND/UCLA appropriateness method.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- What does a failure in anterior cruciate ligament reconstruction really mean? An integrative view.Knee surgery & related research · 2026Review
- APKASS 2024 consensus statement on anterior cruciate ligament reconstruction, Part II: Management of anterior cruciate ligament revision in adults.Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology · 2026Article
- Advances in anterior cruciate ligament reconstruction: Risk stratification, graft choices, and functional recovery in 2026.Journal of experimental orthopaedics · 2026Review
- Anterior Cruciate Ligament Reconstruction Failure: Etiology, Classification, and Revision Strategies-A Narrative Review.Journal of functional morphology and kinesiology · 2026Review
- Combined ACL and ALL Reconstruction Using Allografts as the ACL Graft Source Reduces Surgical Failure and Improves Graft Maturity Compared with Isolated ACL Reconstruction.Journal of clinical medicine · 2026Article
- Artificial ligaments in anterior cruciate ligament reconstruction: Coating strategies for PET-based materials.Journal of orthopaedic translation · 2025Review
- Nationwide Epidemiology of Hospitalized Acute ACL Ruptures in Romania: A 7-Year Analysis (2017-2023).Medicina (Kaunas, Lithuania) · 2025Article
- Risk factors for ACL revision failure and optimum graft size for revision anterior cruciate ligament reconstruction.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Early clinical outcomes of all-inside arthroscopic anterior cruciate ligament reconstruction with autograft tendon augmentation using the LARS internal brace ligament.Frontiers in bioengineering and biotechnology · 2025Article
- Modifiable and non-modifiable risk factors affecting surgical failure after revision ACL reconstruction: a cohort study.Knee surgery & related research · 2024Article
- Refixation of the anterior cruciate ligament: A biomechanical analysis of suture techniques in a porcine model.Journal of experimental orthopaedics · 2024Article
- ESSKA consensus initiative: why, when and how?Journal of experimental orthopaedics · 2023Review
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29 authors.
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Abstract
purposeThe aim of the ESSKA 2022 consensus Part III was to develop patient-focused, contemporary, evidence-based, guidelines on the indications for revision anterior cruciate ligament surgery (ACLRev).
methodsThe RAND/UCLA Appropriateness Method (RAM) was used to provide recommendations on the appropriateness of surgical treatment versus conservative treatment in different clinical scenarios based on current scientific evidence in conjunction with expert opinion. A core panel defined the clinical scenarios with a moderator and then guided a panel of 17 voting experts through the RAM tasks. Through a two-step voting process, the panel established a consensus as to the appropriateness of ACLRev for each scenario based on a nine-point Likert scale (in which a score in the range 1-3 was considered 'inappropriate', 4-6 'uncertain', and 7-9 'appropriate').
resultsThe criteria used to define the scenarios were: age (18-35 years vs 36-50 years vs 51-60 years), sports activity and expectation (Tegner 0-3 vs 4-6 vs 7-10), instability symptoms (yes vs no), meniscus status (functional vs repairable vs non-functional meniscus), and osteoarthritis (OA) (Kellgren-Lawrence [KL] grade 0-I-II vs grade III). Based on these variables, a set of 108 clinical scenarios was developed. ACLRev was considered appropriate in 58%, inappropriate in 12% (meaning conservative treatment is indicated), and uncertain in 30%. Experts considered ACLRev appropriate for patients with instability symptoms, aged ≤ 50 years, regardless of sports activity level, meniscus status, and OA grade. Results were much more controversial in patients without instability symptoms, while higher inappropriateness was related to scenarios with older age (51-60 years), low sporting expectation, non-functional meniscus, and knee OA (KL III).
conclusionThis expert consensus establishes guidelines as to the appropriateness of ACLRev based on defined criteria and provides a useful reference for clinical practice in determining treatment indications. LEVEL OF EVIDENCE: II.
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