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Unrecognized varus malalignment preop
2%
53/2910
Improper bone tunnel placement
95%
2761/2910
Reconstruction with a single bundle
1%
21/2910
Improper graft selection
20/2910
Meniscal injury
38/2910
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Battaglia et al report that "More than 75% of all cases of failed ACL reconstruction are the result of technical error and, of these, more than 70% are attributed specifically to malpositioned tunnels." Varus malalignment (answer 1) can lead to ACLR failure if not also addressed at the time of surgery, but is a less common cause of failure. Anatomic double bundle ACLR (answer #3) has been shown to be better biomechanically, but not clinically. Graft selection (answer #4) among autograft BTB, autograft hamstring, and allograft have not been shown consistently to affect revision rate. Meniscal (answer #5) and articular cartilage injury may affect the long-term satisfaction following ACLR, but are not a common cause of need for revision surgery. The study by Grossman et al reviewed 29 ACL's that underwent revision surgery with good results. All had a positive pivot shift preoperatively..
4.1
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