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A Journal on Orthopedics and Traumatology

Official Journal of the Piedmontese-Ligurian-Lombard Society of Orthopedics and Traumatology
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Minerva Ortopedica e Traumatologica 2014 April;65(2):111-24

language: English

Surgical reasons for failure of anterior cruciate ligament reconstruction

Ryan M. K., Small W., Strauss E. J.

Division of Sports Medicine Department of Orthopedic Surgery, NYU Hospital For Joint Diseases, New York, NY, USA


Anterior cruciate ligament reconstruction (ACLR) is one of the most common surgical procedures performed by orthopedic surgeons. With nearly 200,000 reconstructions performed annually in the United States, the benefits offered from restoring knee joint stability and subsequent return to activity are vast. Although ACLR has been shown to be functionally beneficial and fiscally favorable compared to conservative treatment, there is room to improve. Failure of an ACLR occurs more frequently than desired. Various etiological factors contributing to failure are at play, including traumatic re-rupture, surgical technique, proper rehabilitation and timing of return to activity or sport, lack of graft incorporation, unaddressed associated injuries and unrecognized malalignment. Many of these factors are beyond a surgeon’s control, but those factors within his or her command should be understood thoroughly. Various studies have demonstrated that a majority of failures are attributable to poor surgical technique. The purpose of the current review is to explore the modifiable factors under a surgeon’s control that may potentially result in failure of an anterior cruciate ligament reconstruction.

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