Anterior cruciate ligament failure and management

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. Th...

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Detalles Bibliográficos
Autores: Monllau García, Juan Carlos, Perelli, Simone, Costa, Giuseppe Gianluca
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/59297
Acceso en línea:http://hdl.handle.net/10230/59297
http://dx.doi.org/10.1530/EOR-23-0037
Access Level:acceso abierto
Palabra clave:Anterior cruciate ligament failure
Anterior cruciate ligament revision
Graft choice
Instructional lecture
Osteotomy
Outcomes
Posterior tibial slope
Preoperative planning
Descripción
Sumario: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.