title: Causes for failure of ACL reconstruction and influence of meniscectomies after revision.
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.
authors.affiliation: Service de Chirurgie Orthopédique, Hôpital de l'Archet 2, 151 rte St A. de Ginestière, 06200 Nice, France. Chir-orthopedique@chu-nice.fr
authors.forename: Christophe
authors.initials: C
authors.lastname: Trojani
authors.forename: Abderahmane
authors.initials: A
authors.lastname: Sbihi
authors.forename: Patrick
authors.initials: P
authors.lastname: Djian
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Potel
authors.forename: Christophe
authors.initials: C
authors.lastname: Hulet
authors.forename: Frank
authors.initials: F
authors.lastname: Jouve
authors.forename: Christophe
authors.initials: C
authors.lastname: Bussière
authors.forename: François-Paul
authors.initials: FP
authors.lastname: Ehkirch
authors.forename: Gilles
authors.initials: G
authors.lastname: Burdin
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dubrana
authors.forename: Philippe
authors.initials: P
authors.lastname: Beaufils
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Franceschi
authors.forename: Vincent
authors.initials: V
authors.lastname: Chassaing
authors.forename: Philippe
authors.initials: P
authors.lastname: Colombet
authors.forename: Philippe
authors.initials: P
authors.lastname: Neyret
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D006801:Humans; D008592:Menisci, Tibial / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure