Journal of Medical Sciences (Jan 2023)

Risk factors for failures in anterior cruciate ligament reconstruction: A narrative review

  • Wen-Chun Yen,
  • Zhi-Hong Zheng

DOI
https://doi.org/10.4103/jmedsci.jmedsci_75_23
Journal volume & issue
Vol. 43, no. 5
pp. 197 – 201

Abstract

Read online

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.

Keywords