ACL surgery: reasons for failure and management
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...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-05-01
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| Series: | EFORT Open Reviews |
| Subjects: | |
| Online Access: | https://eor.bioscientifica.com/view/journals/eor/8/5/EOR-23-0085.xml |
| _version_ | 1827950378514120704 |
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| author | Emanuele Diquattro Sonja Jahnke Francesco Traina Francesco Perdisa Roland Becker Sebastian Kopf |
| author_facet | Emanuele Diquattro Sonja Jahnke Francesco Traina Francesco Perdisa Roland Becker Sebastian Kopf |
| author_sort | Emanuele Diquattro |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-09T13:25:01Z |
| format | Article |
| id | doaj.art-1a13674e9e874edc86d20b3324d4b549 |
| institution | Directory Open Access Journal |
| issn | 2058-5241 |
| language | English |
| last_indexed | 2024-04-09T13:25:01Z |
| publishDate | 2023-05-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | EFORT Open Reviews |
| spelling | doaj.art-1a13674e9e874edc86d20b3324d4b5492023-05-10T11:32:42ZengBioscientificaEFORT Open Reviews2058-52412023-05-0185319330https://doi.org/10.1530/EOR-23-0085ACL surgery: reasons for failure and managementEmanuele Diquattro0Sonja Jahnke1Francesco Traina2Francesco Perdisa3Roland Becker4Sebastian Kopf5Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d'anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyCenter of Orthopaedics and Traumatology, University Hospital Brandenburg an der Havel, Medical School Brandenburg, GermanyOrtopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d'anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Bologna, ItalyDepartment of Orthopaedics, Villa Erbosa Hospital, Bologna, ItalyCenter of Orthopaedics and Traumatology, University Hospital Brandenburg an der Havel, Medical School Brandenburg, GermanyCenter of Orthopaedics and Traumatology, University Hospital Brandenburg an der Havel, Medical School Brandenburg, GermanyDespite 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.https://eor.bioscientifica.com/view/journals/eor/8/5/EOR-23-0085.xmlcauses of graft failureacl reconstructionacl revisionacl revision management |
| spellingShingle | Emanuele Diquattro Sonja Jahnke Francesco Traina Francesco Perdisa Roland Becker Sebastian Kopf ACL surgery: reasons for failure and management EFORT Open Reviews causes of graft failure acl reconstruction acl revision acl revision management |
| title | ACL surgery: reasons for failure and management |
| title_full | ACL surgery: reasons for failure and management |
| title_fullStr | ACL surgery: reasons for failure and management |
| title_full_unstemmed | ACL surgery: reasons for failure and management |
| title_short | ACL surgery: reasons for failure and management |
| title_sort | acl surgery reasons for failure and management |
| topic | causes of graft failure acl reconstruction acl revision acl revision management |
| url | https://eor.bioscientifica.com/view/journals/eor/8/5/EOR-23-0085.xml |
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