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Causes for failure of ACL reconstruction and influence of meniscectomies after revision

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The purpose of this multicenter retrospective study was to analyze the causes for failure of ACL reconstruction and the influence of meniscectomies after revision. This study was conducted over a 12-year period, from 1994 to 2005 with ten French orthopaedic centers participating. Assessment included the objective International Knee Documenting Committee (IKDC) 2000 scoring system evaluation. Two hundred and ninety-three patients were available for statistics. Untreated laxity, femoral and tibial tunnel malposition, impingement, failure of fixation were assessed, new traumatism and infection were recorded. Meniscus surgery was evaluated before, during or after primary ACL reconstruction, and then during or after revision ACL surgery. The main cause for failure of ACL reconstruction was femoral tunnel malposition in 36% of the cases. Forty-four percent of the patients with an anterior femoral tunnel as a cause for failure of the primary surgery were IKDC A after revision versus 24% if the cause of failure was not the femoral tunnel (P = 0.05). A 70% meniscectomy rate was found in revision ACL reconstruction. Comparison between patients with a total meniscectomy (n = 56) and patients with preserved menisci (n = 65) revealed a better functional result and knee stability in the non-meniscectomized group (P = 0.04). This study shows that the anterior femoral tunnel malposition is the main cause for failure in ACL reconstruction. This reason for failure should be considered as a predictive factor of good result of revision ACL reconstruction. Total meniscectomy jeopardizes functional result and knee stability at follow-up.

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Authors and Affiliations

  1. Service de Chirurgie Orthopédique, Hôpital de l’Archet 2, 151 rte St A. de Ginestière, 06200, Nice, France

    Christophe Trojani

  2. Cabinet Medical, 118 rue Jean Mermoz, 13008, Marseille, France

    Abderahmane Sbihi

  3. Cabinet Goethe, 23 avenue Niel, 75017, Paris, France

    Patrick Djian

  4. Clinique du Cours Dillon, 1 rue Peyrolade, 31300, Toulouse, France

    Jean-François Potel

  5. Département d’Orthopédie, CHU de Caen, 14033, Caen Cedex, France

    Christophe Hulet

  6. Clinique St George, av de Rimiez, 06000, Nice, France

    Frank Jouve

  7. Clinique Du Val Fleuri, rue de l Héritan, 71000, Macon, France

    Christophe Bussière

  8. Clinique des Maussins, 67 Rue de Romainville, 75019, Paris, France

    François-Paul Ehkirch & Vincent Chassaing

  9. Orthoipédie, CHU de Caen, Avenue de la Côte-de- Nacre, 14033, Caen cedex, France

    Gilles Burdin

  10. Service Orthopédie CHU Cavale Blanche, 29200, Brest, France

    Frédéric Dubrana

  11. Hôpital A. Mignot, 78157, Le Chesnay Cedex, France

    Philippe Beaufils

  12. Hôpital de la Conception, Service Prof Groulier, 13005, Marseille, France

    Jean-Pierre Franceschi

  13. 9 rue Jean Moulin, 33700, Mérignac, France

    Philippe Colombet

  14. Centre Livet, 8 rue de Margnolles, 69300, Caluire, France

    Philippe Neyret

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  1. Christophe Trojani
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  2. Abderahmane Sbihi
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  13. Vincent Chassaing
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  14. Philippe Colombet
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  15. Philippe Neyret
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Correspondence to Christophe Trojani.

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Trojani, C., Sbihi, A., Djian, P. et al. Causes for failure of ACL reconstruction and influence of meniscectomies after revision. Knee Surg Sports Traumatol Arthrosc 19, 196–201 (2011). https://doi.org/10.1007/s00167-010-1201-6

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  • DOI: https://doi.org/10.1007/s00167-010-1201-6

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