Trauma and femoral tunnel position are the most common failure modes of anterior cruciate ligament reconstruction : a systematic review
PURPOSE: To improve outcomes of anterior cruciate ligament reconstruction (ACLR), it is important to understand the reasons for failure of this procedure. This systematic review was performed to identify current failure modes of ACLR.
METHODS: A systematic search was performed using PubMed, EMBASE, Cochrane, and annual registries for ACLR failures. Studies were included when failure modes were reported (I) of ≥ 10 patients and (II) at a minimum of two-year follow-up. Modes of failure were also compared between different graft types and in femoral tunnel positions.
RESULTS: This review included 24 cohort studies and 4 registry-based studies (1 level I, 1 level II, 10 level III, and 16 level IV studies). Overall, a total of 3657 failures were identified. The most common single failure mode of ACLR was new trauma (38%), followed by technical errors (22%), combined causes (i.e. multiple failure mechanisms; 19%), and biological failures (i.e. failure due to infection or laxity without traumatic or technical considerations; 8%). Technical causes also played a contributing role in 17% of all failures. Femoral tunnel malposition was the most common cause of technical failure (63%). When specifically looking at the bone-patellar tendon-bone (BPTB) or hamstring (HT) autografts, trauma was the most common failure mode in both, whereas biological failure was more pronounced in the HT group (4% vs. 22%, respectively). Technical errors were more common following transtibial as compared to anteromedial portal techniques (49% vs. 26%).
CONCLUSION: Trauma is the single leading cause of ACLR failure, followed by technical errors, and combined causes. Technical errors seemed to play a major or contributing role in large part of reported failures, with femoral tunnel malposition being the leading cause of failure. Trauma was also the most common failure mode in both BPTB and HT grafts. Technical errors were a more common failure mode following transtibial than anteromedial portal technique.
LEVEL OF EVIDENCE: IV.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
|---|---|
| Enthalten in: |
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA - 28(2020), 11 vom: 21. Nov., Seite 3666-3675 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Vermeijden, Harmen D [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anterior cruciate ligament |
|---|
| Anmerkungen: |
Date Completed 09.02.2021 Date Revised 09.02.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00167-020-06160-9 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM312673876 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM312673876 | ||
| 003 | DE-627 | ||
| 005 | 20231225144924.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00167-020-06160-9 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1042.xml |
| 035 | |a (DE-627)NLM312673876 | ||
| 035 | |a (NLM)32691095 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Vermeijden, Harmen D |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Trauma and femoral tunnel position are the most common failure modes of anterior cruciate ligament reconstruction |b a systematic review |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 09.02.2021 | ||
| 500 | |a Date Revised 09.02.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: To improve outcomes of anterior cruciate ligament reconstruction (ACLR), it is important to understand the reasons for failure of this procedure. This systematic review was performed to identify current failure modes of ACLR | ||
| 520 | |a METHODS: A systematic search was performed using PubMed, EMBASE, Cochrane, and annual registries for ACLR failures. Studies were included when failure modes were reported (I) of ≥ 10 patients and (II) at a minimum of two-year follow-up. Modes of failure were also compared between different graft types and in femoral tunnel positions | ||
| 520 | |a RESULTS: This review included 24 cohort studies and 4 registry-based studies (1 level I, 1 level II, 10 level III, and 16 level IV studies). Overall, a total of 3657 failures were identified. The most common single failure mode of ACLR was new trauma (38%), followed by technical errors (22%), combined causes (i.e. multiple failure mechanisms; 19%), and biological failures (i.e. failure due to infection or laxity without traumatic or technical considerations; 8%). Technical causes also played a contributing role in 17% of all failures. Femoral tunnel malposition was the most common cause of technical failure (63%). When specifically looking at the bone-patellar tendon-bone (BPTB) or hamstring (HT) autografts, trauma was the most common failure mode in both, whereas biological failure was more pronounced in the HT group (4% vs. 22%, respectively). Technical errors were more common following transtibial as compared to anteromedial portal techniques (49% vs. 26%) | ||
| 520 | |a CONCLUSION: Trauma is the single leading cause of ACLR failure, followed by technical errors, and combined causes. Technical errors seemed to play a major or contributing role in large part of reported failures, with femoral tunnel malposition being the leading cause of failure. Trauma was also the most common failure mode in both BPTB and HT grafts. Technical errors were a more common failure mode following transtibial than anteromedial portal technique | ||
| 520 | |a LEVEL OF EVIDENCE: IV | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Anterior cruciate ligament | |
| 650 | 4 | |a Biological | |
| 650 | 4 | |a Failure modes | |
| 650 | 4 | |a Reconstruction | |
| 650 | 4 | |a Systematic review | |
| 650 | 4 | |a Technical | |
| 650 | 4 | |a Traumatic | |
| 700 | 1 | |a Yang, Xiuyi A |e verfasserin |4 aut | |
| 700 | 1 | |a van der List, Jelle P |e verfasserin |4 aut | |
| 700 | 1 | |a DiFelice, Gregory S |e verfasserin |4 aut | |
| 700 | 1 | |a Rademakers, Maarten V |e verfasserin |4 aut | |
| 700 | 1 | |a Kerkhoffs, Gino M M J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |d 1997 |g 28(2020), 11 vom: 21. Nov., Seite 3666-3675 |w (DE-627)NLM075292165 |x 1433-7347 |7 nnns |
| 773 | 1 | 8 | |g volume:28 |g year:2020 |g number:11 |g day:21 |g month:11 |g pages:3666-3675 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00167-020-06160-9 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 28 |j 2020 |e 11 |b 21 |c 11 |h 3666-3675 | ||