Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic Review
Purpose: To assess the consistency of risk factor reporting for anterior cruciate ligament reconstruction (ACLR) failure after primary reconstruction, identify risk factors more frequently associated with ACLR failure, and help clinicians prevent reinjury in patients with risk factors for ACLR failu...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-04-01
|
| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X2500001X |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850200763338326016 |
|---|---|
| author | Jeffrey Lee, B.S. Johnathon R. McCormick, M.D. Kevin Credille, M.D. Navya Dandu, M.D. Zachary Wang, B.S. Nicholas A. Trasolini, M.D. Reem Y. Darwish, B.S. Jorge Chahla, M.D., Ph.D. Adam B. Yanke, M.D., Ph.D. |
| author_facet | Jeffrey Lee, B.S. Johnathon R. McCormick, M.D. Kevin Credille, M.D. Navya Dandu, M.D. Zachary Wang, B.S. Nicholas A. Trasolini, M.D. Reem Y. Darwish, B.S. Jorge Chahla, M.D., Ph.D. Adam B. Yanke, M.D., Ph.D. |
| author_sort | Jeffrey Lee, B.S. |
| collection | DOAJ |
| description | Purpose: To assess the consistency of risk factor reporting for anterior cruciate ligament reconstruction (ACLR) failure after primary reconstruction, identify risk factors more frequently associated with ACLR failure, and help clinicians prevent reinjury in patients with risk factors for ACLR failure. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to conduct a systematic review. Initial title and abstract screening yielded 561 studies, from which 76 studies were assessed for eligibility. Thirty-two full-text studies met the following inclusion criteria: (1) clinical studies of anterior cruciate ligament injuries; (2) patients undergoing ACLR; (3) clinical outcome data, including failure rate; (4) studies assessing preoperative risk factors for failure; and (5) manuscripts published within the past 6 years. These studies were subdivided into those that defined ACLR failure as revision surgery or graft failure. Results: Ten risk factors were included in the review for 22 studies defining ACLR failure as revision surgery. Eight risk factors were included in the review for 10 studies defining ACLR failure as graft failure. Posterior tibial slope (PTS) (80%, 4/5 studies), age (79%, 11/14 studies), and graft characteristics (71%, 5/7 studies) such as allograft versus bone–patellar tendon–bone autograft, high-dose radiation, and BioCleanse preparation technique were the most significant risk factors for revision ACLR. PTS (100%, 2/2 studies) and activity level (67%, 2/3 studies) were the most significant risk factors for graft failure. Conclusions: Age, PTS, use of allograft, and activity level are significant preoperative risk factors that should be considered when attempting to prevent reinjury in ACLR candidates. Studies investigating risk factors for ACLR failure often fail to control for confounding variables that can influence outcomes. Level of Evidence: Level IV, systematic review of Level II to IV studies, |
| format | Article |
| id | doaj-art-2dc3e314658f4bb08561a10a3c944512 |
| institution | OA Journals |
| issn | 2666-061X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj-art-2dc3e314658f4bb08561a10a3c9445122025-08-20T02:12:14ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2025-04-017210107510.1016/j.asmr.2025.101075Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic ReviewJeffrey Lee, B.S.0Johnathon R. McCormick, M.D.1Kevin Credille, M.D.2Navya Dandu, M.D.3Zachary Wang, B.S.4Nicholas A. Trasolini, M.D.5Reem Y. Darwish, B.S.6Jorge Chahla, M.D., Ph.D.7Adam B. Yanke, M.D., Ph.D.8Department of Orthopedics, Rush University Medical Center, Chicago, Illinois, U.S.A.Department of Orthopedics, Rush University Medical Center, Chicago, Illinois, U.S.A.Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, Texas, U.S.A.Department of Orthopedics, Rush University Medical Center, Chicago, Illinois, U.S.A.Department of Orthopedics, Rush University Medical Center, Chicago, Illinois, U.S.A.Department of Orthopedics, Rush University Medical Center, Chicago, Illinois, U.S.A.Department of Orthopedics, Rush University Medical Center, Chicago, Illinois, U.S.A.Department of Orthopedics, Rush University Medical Center, Chicago, Illinois, U.S.A.Department of Orthopedics, Rush University Medical Center, Chicago, Illinois, U.S.A.; Address correspondence to Adam B. Yanke, M.D., Ph.D., 1611 W Harrison St, St 300, Chicago, IL 60612, U.S.A.Purpose: To assess the consistency of risk factor reporting for anterior cruciate ligament reconstruction (ACLR) failure after primary reconstruction, identify risk factors more frequently associated with ACLR failure, and help clinicians prevent reinjury in patients with risk factors for ACLR failure. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to conduct a systematic review. Initial title and abstract screening yielded 561 studies, from which 76 studies were assessed for eligibility. Thirty-two full-text studies met the following inclusion criteria: (1) clinical studies of anterior cruciate ligament injuries; (2) patients undergoing ACLR; (3) clinical outcome data, including failure rate; (4) studies assessing preoperative risk factors for failure; and (5) manuscripts published within the past 6 years. These studies were subdivided into those that defined ACLR failure as revision surgery or graft failure. Results: Ten risk factors were included in the review for 22 studies defining ACLR failure as revision surgery. Eight risk factors were included in the review for 10 studies defining ACLR failure as graft failure. Posterior tibial slope (PTS) (80%, 4/5 studies), age (79%, 11/14 studies), and graft characteristics (71%, 5/7 studies) such as allograft versus bone–patellar tendon–bone autograft, high-dose radiation, and BioCleanse preparation technique were the most significant risk factors for revision ACLR. PTS (100%, 2/2 studies) and activity level (67%, 2/3 studies) were the most significant risk factors for graft failure. Conclusions: Age, PTS, use of allograft, and activity level are significant preoperative risk factors that should be considered when attempting to prevent reinjury in ACLR candidates. Studies investigating risk factors for ACLR failure often fail to control for confounding variables that can influence outcomes. Level of Evidence: Level IV, systematic review of Level II to IV studies,http://www.sciencedirect.com/science/article/pii/S2666061X2500001X |
| spellingShingle | Jeffrey Lee, B.S. Johnathon R. McCormick, M.D. Kevin Credille, M.D. Navya Dandu, M.D. Zachary Wang, B.S. Nicholas A. Trasolini, M.D. Reem Y. Darwish, B.S. Jorge Chahla, M.D., Ph.D. Adam B. Yanke, M.D., Ph.D. Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic Review Arthroscopy, Sports Medicine, and Rehabilitation |
| title | Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic Review |
| title_full | Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic Review |
| title_fullStr | Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic Review |
| title_full_unstemmed | Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic Review |
| title_short | Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic Review |
| title_sort | patient age and activity level posterior tibial slope and use of allograft are significant risk factors for anterior cruciate ligament reconstruction failure a systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X2500001X |
| work_keys_str_mv | AT jeffreyleebs patientageandactivitylevelposteriortibialslopeanduseofallograftaresignificantriskfactorsforanteriorcruciateligamentreconstructionfailureasystematicreview AT johnathonrmccormickmd patientageandactivitylevelposteriortibialslopeanduseofallograftaresignificantriskfactorsforanteriorcruciateligamentreconstructionfailureasystematicreview AT kevincredillemd patientageandactivitylevelposteriortibialslopeanduseofallograftaresignificantriskfactorsforanteriorcruciateligamentreconstructionfailureasystematicreview AT navyadandumd patientageandactivitylevelposteriortibialslopeanduseofallograftaresignificantriskfactorsforanteriorcruciateligamentreconstructionfailureasystematicreview AT zacharywangbs patientageandactivitylevelposteriortibialslopeanduseofallograftaresignificantriskfactorsforanteriorcruciateligamentreconstructionfailureasystematicreview AT nicholasatrasolinimd patientageandactivitylevelposteriortibialslopeanduseofallograftaresignificantriskfactorsforanteriorcruciateligamentreconstructionfailureasystematicreview AT reemydarwishbs patientageandactivitylevelposteriortibialslopeanduseofallograftaresignificantriskfactorsforanteriorcruciateligamentreconstructionfailureasystematicreview AT jorgechahlamdphd patientageandactivitylevelposteriortibialslopeanduseofallograftaresignificantriskfactorsforanteriorcruciateligamentreconstructionfailureasystematicreview AT adambyankemdphd patientageandactivitylevelposteriortibialslopeanduseofallograftaresignificantriskfactorsforanteriorcruciateligamentreconstructionfailureasystematicreview |