Causes for failure of ACL reconstruction and influence of meniscectomies after revision

Trojani, Christophe; Sbihi, A.; Djian, P.; Potel, J.-F.; Hulet, C.; Jouve, Frank; Bussière, C.; Ehkirch, F.-P.; Burdin, G.; Dubrana, F.; Beaufils, Philippe; Franceschi, J.-P.; Chassaing, V.; Colombet, Philippe; Neyret, Philippe

doi:10.1007/s00167-010-1201-6

Cited by 224 publications

(166 citation statements)

References 41 publications

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“…In the present study, tunnel positioning in the primary ACL reconstruction was correct in only 6 out of 34 patients (17.6%). Malposition of the femoral tunnel accounted for primary graft failure in 28 cases (82.4%), which was at the high end of the previously reported range (37-85%) (28)(29)(30)(31). The lesions of the anterior cruciate ligament identified intra-operatively in the present study included graft absorption (n=4, 11.8%), ACL rupture (n=10, 29.4%) and ACL laxity (n=20, 58.8%).…”

Section: Discussionsupporting

confidence: 44%

Double-bundle revision anterior cruciate ligament reconstruction is effective in rescuing failed primary reconstruction and re-introducing patients to physical exercise

Jiang

Chen

et al. 2017

Exp Ther Med

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Abstract. The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments in the human knee and is critical for knee stability, as it limits anterior tibial translation on the femur, restrains rotation and resists varus and valgus joint forces. The present study aimed to assess the effect of double-bundle revision anterior cruciate ligament (ACL) reconstruction in improving the subjective and objective functions and re-introducing patients to physical activity after primary ACL reconstruction had failed. A total of 34 patients who underwent double-bundle ACL revision surgeries were included in the present retrospective study. Lysholm, Tegner and IKDC scores as well as KT-2000 arthrometry measures were obtained pre-and post-operatively. The follow-up time was at least 2 years. The results indicated that the IKDC, Lysholm and Tegner scores as well as KT-2000 flexion scores were significantly improved after revision ACL reconstruction. All patients resumed to performing physical exercise activities after revision surgeries, 65% of whom reached pre-injury levels. In conclusion, these results demonstrated that double-bundle revision ACL reconstruction was consistently effective in rescuing failed primary ACL reconstruction and re-introducing patients to physical exercise.

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Section: Discussionsupporting

confidence: 44%

Double-bundle revision anterior cruciate ligament reconstruction is effective in rescuing failed primary reconstruction and re-introducing patients to physical exercise

Jiang

Chen

et al. 2017

Exp Ther Med

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“…Parkinson et al [31] found that meniscal integrity was the strongest predictor of ACL reconstruction failure. Increased graft laxity was found in ACL reconstruction patients with medial meniscal deficiency [32], and a higher incidence of a residual pivot shift was reported in meniscal-deficient knees [33]. Greater stress through the ACL graft in meniscal-deficient knees may explain a higher graft failure rate [31].…”

Section: Late Post-operative Complicationsmentioning

confidence: 98%

Prevention and Management of Post-operative Complications Following ACL Reconstruction

Eckenrode

Carey

Sennett

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of Review The goal of this paper is to review the current management and prevention of post-operative complications after anterior cruciate ligament (ACL) reconstruction. Trends in rehabilitation techniques will be presented, in addition to suggestions for interventions and expected milestones in ACL reconstruction recovery. Recent Findings ACL reconstruction protocols have evolved to more of a criterion-based progression rather than a tissuehealing time frame. Given the evolution of ACL surgical reconstruction techniques and rehabilitation protocols, the risk of post-operative complications can arise both early and late in the recovery process. This paper will discuss the role of preventative measures as it applies to the post-operative patient with ACL reconstruction. Summary Short-term complications following ACL reconstruction include infection and deficits to knee motion and strength, whereas long-term complications include secondary ACL injury to either the involved or contralateral knee and lack of ability to return to high-level sports following this procedure. Future research should continue to address the multifactorial causes of secondary ACL injury and limited ability of patients to return to high level activities.

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“…For a variety of reasons a considerable number of patients are not satisfied or experience pain after anterior cruciate ligament (ACL) reconstruction [1][2][3][4][5]. Typical reasons include failure of the ACL graft, failure of graft fixation, chronic synovitis due to biodegradable fixation material and missed concomitant injuries [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Typical reasons include failure of the ACL graft, failure of graft fixation, chronic synovitis due to biodegradable fixation material and missed concomitant injuries [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

SPECT/CT tracer uptake is influenced by tunnel orientation and position of the femoral and tibial ACL graft insertion site

Hirschmann

Mathis

Rasch

et al. 2012

International Orthopaedics (SICOT)

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Purpose SPECT/CT is a hybrid imaging modality, which combines a 3D scintigraphy (SPECT) and a conventional computerised tomography (CT). SPECT/CT allows accurate anatomical localisation of metabolic tracer activity. It allows the correlation of surgical factors such as tunnel position and orientation with mechanical alignment, clinical outcome and biological factors. The purpose of this study was to investigate whether the SPECT/CT tracer uptake (intensity and distribution) correlates with the stability and laxity of the knee joint and the position and orientation of the tibial and femoral tunnels in patients after anterior cruciate ligament (ACL) reconstruction. Methods A consecutive series of knees (n066), with symptoms of pain and/or instability after ACL reconstruction were prospectively evaluated using clinical examination and 99mTc-HDP-SPECT/CT. Clinical laxity testing was performed using the Rolimeter (Ormed, Freiburg, Germany) including Lachman testing (0-2 mm, 3-5 mm, 6-10 mm, >10 mm), anterior drawer test (0-2 mm, 3-5 mm, 6-10 mm, >10 mm), pivot shift test (positive versus negative) and patientbased subjective instability (yes versus no).For analysis of SPECT/CT tracer uptake a previously validated SPECT/CT localisation scheme consisting of 17 tibial, nine femoral and four patellar regions on standardised axial, coronal, and sagittal slices was used. The tracer activity on SPECT/CT was localised and recorded using a 3D volumetric and quantitative analysis software.Mean, standard deviation, minimum and maximum of grading for each area of the localisation scheme were recorded. The position and orientation of the tibial and femoral tunnel was assessed using a previously published method on 3D-CT. Results Correlation of instability, pivot shift as well as clinical laxity testing with 99mTc-HDP-SPECT/CT tracer uptake intensity and distribution showed no significant correlation. 99mTc-HDP-SPECT/CT tracer uptake correlated significantly with the position and orientation of the ACL graft. A more horizontal femoral graft position showed significantly increased tracer uptake within the superior and posterior femoral regions. A more posteriorly-placed femoral insertion site showed significantly more tracer uptake within the femoral and tibial tunnel regions. A more vertical or a less medial tibial tunnel orientation showed significant increased uptake within the tibial and femoral tunnel regions. A more anterior tibial tunnel position showed significantly more tracer uptake in the femoral and tibial tunnel regions as well as the entire tibiofemoral joint. Conclusions SPECT/CT tracer uptake intensity and distribution showed a significant correlation with the femoral and tibial tunnel position and orientation in patients with symptomatic knees after ACL reconstruction. No correlation was found with stability or clinical laxity.Michael T. Hirschmann and Dominic Mathis contributed equally to this paper.

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Causes for failure of ACL reconstruction and influence of meniscectomies after revision

Cited by 224 publications

References 41 publications

Double-bundle revision anterior cruciate ligament reconstruction is effective in rescuing failed primary reconstruction and re-introducing patients to physical exercise

Double-bundle revision anterior cruciate ligament reconstruction is effective in rescuing failed primary reconstruction and re-introducing patients to physical exercise

Prevention and Management of Post-operative Complications Following ACL Reconstruction

SPECT/CT tracer uptake is influenced by tunnel orientation and position of the femoral and tibial ACL graft insertion site

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