Causes of Failure of Anterior Cruciate Ligament Reconstruction and Revision Surgical Strategies
| Autor: | Paolo Di Benedetto, Alessandro Beltrame, and Araldo Causero, Enrico Daniele Di Benedetto, Andrea Fiocchi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Graft failure Anterior cruciate ligament reconstruction Revision medicine.medical_treatment Anterior cruciate ligament Failure 03 medical and health sciences 0302 clinical medicine medicine Failure causes Orthopedics and Sports Medicine Knee High rate 030222 orthopedics Preoperative planning Reconstruction business.industry 030229 sport sciences musculoskeletal system Surgery medicine.anatomical_structure Etiology Patient evaluation Original Article business |
| Zdroj: | Knee Surgery & Related Research |
| Popis: | Purpose Long-term outcomes of anterior cruciate ligament (ACL) reconstruction are good or excellent; however, 0.7%-20% of patients suffer from recurrent instability due to graft failure. The purpose of this paper was to analyse failure aetiology and the possibilities of revision surgical strategies, with a description of our experience. We obtained optimal and good results in most of our patients. Materials and methods We retrospectively reviewed 42 patients who underwent revision surgery (43 revisions) due to relapsing instability after ACL reconstruction between 2006 and 2015. We used allografts in 39 cases and autografts in 4 cases. Results The 85.7% of the patients obtained optimal results (normal knee; group A) and the 7.2% obtained good results (nearly normal knee; group B) according to the International Knee Documentation Committee score. The most frequent failure causes were traumatic events, non-anatomic tunnel placement, and lack of graft incorporation. Conclusions A correct revision surgery requires accurate patient evaluation and knee imaging. Preoperative planning starts with the identification of the cause of failure of the primary reconstruction. Then, the most suitable procedure should be determined for each case. It is also important to accurately inform the patient of all the complexity of an ACL revision surgery even if it is a procedure with high rates of excellent and good outcomes. |
| Databáze: | OpenAIRE |
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