Risk factors for failures in anterior cruciate ligament reconstruction: A narrative review Yen WC, Zheng ZH, - J Med Sci

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Risk factors for failures in anterior cruciate ligament reconstruction: A narrative review Wen-Chun Yen¹, Zhi-Hong Zheng² ¹ Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan ² Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei; Department of Orthopedic Surgery, Hualien Armed Forces General Hospital, Hualien; Department of Orthopedic Surgery, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan Correspondence Address: Zhi-Hong Zheng, Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Neihu Dist., Taipei Taiwan Source of Support: None, Conflict of Interest: None DOI: 10.4103/jmedsci.jmedsci_75_23

This article provides a narrative review of the risk factors for anterior cruciate ligament reconstruction (ACLR) failures, as well as strategies to prevent such failures. Early timing for ACLR is not a risk factor for arthrofibrosis anymore according to recent studies. Vancomycin-soaked grafts appear to decrease infection rates after ACLR and are cost-effective. Proper tunnel placement is critical for anatomic ACLR to restore knee kinematics and joint stability. The article proposes a reproducible and accurate method for tunnel positioning. Increased sagittal plane tibial slope has been identified as a risk factor for primary ACLR failure. An anterior closing wedge proximal tibial osteotomy is suggested as a viable option for reducing posterior tibial slope. The lateral extra-articular tenodesis procedure in ACLR is effective in restoring both anterior tibial translation and rotatory stability.

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    -  Zheng ZH

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