Failure modes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis

Li, Xiaoke; Yan, Lei; Li, Dijun; Fan, Zijuan; Liu, Haifeng; Wang, Guishan; Jiu, Jingwei; Yang, Ziquan; Li, Jiao Jiao; Wang, Bin

doi:10.1007/s00264-023-05687-z

Cited by 11 publications

(3 citation statements)

References 79 publications

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“…The reason for graft failure after ACL-R has been assumed to be multifactorial ( 17 , 18 , 19 ). Thus, it often remains difficult to find the one reason for the failure of an ACL-R ( 20 ).…”

Section: Reasons Of Failurementioning

confidence: 99%

ACL surgery: reasons for failure and management

et al. 2023

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Despite the general success of anterior cruciate ligament reconstructions (ACL-R), there are still studies reporting a high failure rate. Orthopedic surgeons are therefore increasingly confronted with the treatment of ACL retears, which are often accompanied by other lesions, such as meniscus tears and cartilage damage and which, if overlooked, can lead to poor postoperative clinical outcomes. The literature shows a wide variety of causes for ACL-R failure. Main causes are further trauma and possible technical errors during surgery, among which the position of the femoral tunnel is thought to be one of the most important. A successful postoperative outcome after ACL-revision surgery requires good preoperative planning, including a thorough evaluation of patient's medical history, e.g. instability during daily or sports activity, increased general joint laxity, and hints for a low-grade infection. A careful clinical examination should be performed. Additionally, comprehensive imaging is necessary. Besides a magnetic resonance imaging, a CT scan is helpful to determine location of tunnel apertures and to analyze for tunnel enlargement. A lateral knee radiograph is helpful to determine the tibial slope. The range of surgical options for the treatment of ACL-R failure is broad today. Orthopedic surgeons and experts in Sports Medicine must deal with various possible associated injuries of the knee or unfavorable anatomical conditions for ACL-R. The aim of this review was to highlight predictors and reasons of failures of ACL-R as well as describe diagnostic procedures to individualize treatment strategies for improved outcome after revision ACL-R.

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Section: Reasons Of Failurementioning

confidence: 99%

ACL surgery: reasons for failure and management

et al. 2023

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“…За последнее десятилетие реконструкция передней крестообразной связки (ПКС) становится все более распространенным ортопедическим оперативным вмешательством в связи с ростом количества травматических повреждений связочного аппарата коленного сустава (КС) вследствие повышения уровня спортивной и повседневной активности среди людей трудоспособного возраста [1,2,3]. Несмотря на постоянное совершенствование хирургических подходов к первичному восстановлению ПКС, частота ревизионных реконструкций продолжает расти и, по данным разных авторов, может составлять до 25% [4,5,6]. Это связано с множеством факторов риска развития первичной несостоятельности трансплантата ПКС, которые нередко не учитываются хирургами как при предоперационном планировании, так и непосредственно во время операции [7].…”

Section: Introductionunclassified

Peroneus longus tendon autograft for one-stage revision acl reconstruction: mid-term results

Gofer,

Alekperov,

Gurazhev

et al. 2024

Traumatology and Orthopedics of Russia

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Background. The results of revision anterior cruciate ligament reconstruction (ACLR) are usually worse than primary ACLR. The positive outcome of the revision ACLR is significantly influenced by the following factors: anatomical position of bone tunnels, correct of graft choice, preparation, and fixation method, as well as appropriate determination of indications for additional extra articular interventions. Aim of the study was to evaluate the results after a single-stage revision ACLR using a peroneus longus tendon (PLT) autograft and compare them with the results of primary ACLR performed using a standard technique using a hamstring tendons (HT). Methods. The comparison was carried out between the study group – "RACL-PLT" (n=29) – single-stage revision ACLR using an PLT autograft and the control group – "PACL–HT" (n=82) – primary ACLR according to a standard procedure using a HT autograft. Subjective and objective evaluation using the KOOS, IKDC, and Lysholm scales was performed, and the position of the central entry points into the primary and revision tunnels was also determined in the «RACL-PLT» group. Results. There were no statistically significant differences in the results of an objective assessment of knee joint stability between the groups (p0.999). Significantly higher results of subjective assessment on the Lysholm, KOOS and IKDC scales were obtained in the «PACL-HT» group (p 0.001). The position of the central entry points into the revision tunnels corresponded to the normative values in all cases. Conclusion. The analysis of the use PLT autograft in revision ACLR, as well as the achievement of the anatomical position of the revision tunnels, showed that the results of the subjective assessment of the revision and primary ACLR are significantly different, and the results of the objective assessment are comparable.

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“…Posterior cruciate ligament (PCL) injuries are rare, with the majority of cases associated with traffic or sports accidents [16, 17, 19], and account for only 1% of traumatic knee lesions [26]. However, long‐term studies have shown an increased incidence of osteoarthritic lesions and deterioration of knee function in patients who are treated nonsurgically [4, 22].…”

Section: Introductionmentioning

confidence: 99%

The tibial capsular reflection and septum in posterior compartment are safe and reliable soft‐tissue landmark for tibial tunnel drilling in posterior cruciate ligament reconstruction

Niu,

Li,

Chen

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo investigate the validity of using tibial capsular reflection and septum in the posterior compartment as landmark during posterior cruciate ligament (PCL) reconstruction (PCLR).MethodsAnatomic measurements were obtained for 12 fresh human cadaveric knee specimens to observe the spatial position of the tibial insertion of the PCL in relation to the posterior septum and the capsular reflection in the posterior compartment. Sixty patients who underwent reconstruction of the PCL between 2020 and 2023 were also retrospectively investigated. The tibial tunnel was replaced in all patients using the same method (with reference to the tibial capsular reflection and the posterior septum). The placement of the tibial tunnel was assessed using X‐ray fluoroscopy intraoperatively and computed tomography and three‐dimensional reconstruction postoperatively.ResultsAll fibres in the tibial insertion of the PCL in the 12 cadaveric specimens were located in the posteromedial compartment, adjacent to the posterior septum. The inferior border of the PCL insertion is adjacent to the tibial capsular reflection, which is attached at the champagne glass drop‐off of the posterior tibia. In our previous cases, none of the patients experienced postoperative or intraoperative complications such as neurovascular injury, and the angle between the pin and the PCL facet was 93.1 ± 3.9° as measured on intraoperative radiographs. The mean distance from the centre of the tibial tunnel outlet to the inferior border of the PCL insertion was 5.6 ± 1.1 mm, and the distance from the centre of the tibial tunnel outlet to the outer border of the PCL insertion as a percentage of the length of the inferior border of PCL insertion was 42.2 ± 6.3%.ConclusionThe tibial capsular reflection and septum in the posterior compartment are safe and reliable soft‐tissue landmark for tibial tunnel drilling in PCLR.Level of EvidenceLevel Ⅳ.

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Failure modes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis

Cited by 11 publications

References 79 publications

ACL surgery: reasons for failure and management

ACL surgery: reasons for failure and management

Peroneus longus tendon autograft for one-stage revision acl reconstruction: mid-term results

The tibial capsular reflection and septum in posterior compartment are safe and reliable soft‐tissue landmark for tibial tunnel drilling in posterior cruciate ligament reconstruction

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