Anterior cruciate ligament failure and management

Author:

Monllau Juan Carlos12ORCID,Perelli Simone12,Costa Giuseppe Gianluca3

Affiliation:

1. Department of Orthopaedic Surgery, Hospital del Mar, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain

2. ICATKnee, Institut Catalá de Traumatologia i Medicina de l’Esport (ICATME), Hospital Universitari Dexeus, UAB, Barcelona, Spain

3. Orthopaedic Surgery Department, Ospedale Umberto I, Enna, Italy

Abstract

Anterior cruciate ligament (ACL) reconstruction failure can be defined as abnormal knee function due to graft insufficiency with abnormal laxity or failure to recreate a functional knee according to the expected outcome. Traumatic ruptures have been reported as the most common reason for failure. They are followed by technical errors, missed concomitant knee injuries, and biological failures. An in-depth preoperative examination that includes a medical history, clinical examinations, advanced imaging, and other appropriate methods is of utmost importance. There is still no consensus as to the ideal graft, but autografts are the favorite choice even in ACL revision. Concomitant meniscal treatment, ligamentous reconstruction, and osteotomies can be performed in the same surgical session to remove anatomical or biomechanical risk factors for the failure. Patient expectations should be managed since outcomes after ACL revision are not as good as those following primary ACL reconstruction.

Publisher

Bioscientifica

Subject

Orthopedics and Sports Medicine,Surgery

Reference137 articles.

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3. ACL graft and contralateral ACL tear risk within ten years following reconstruction: a systematic review;Magnussen,2015

4. Ipsilateral graft and contralateral ACL rupture at five years or more following ACL reconstruction: a systematic review;Wright,2011

5. Clinical outcomes and osteoarthritis at very long-term follow-up after ACL reconstruction: a systematic review and meta-analysis;Grassi,2022

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