Rajesh Bhalla

Why did my ACL Reconstruction Surgery Fail?

These days, the ACL Reconstruction surgery is considered as one of the important surgical procedure in the field of orthopedic treatments and therapies. As precision and accuracy play an important role in the success of surgery, likewise, several factors lead to ACL reconstruction failure. Under such conditions, the procedure needs to be revised to offer complete relief for the patient. But, why does an ACL reconstruction failure?

To find out the right answer to this question, let’s try first to understand what is the ACL reconstruction surgery.

What is an ACL Reconstruction Surgery?

The ACL Reconstruction surgery refers to the surgical procedure performed to replace the Anterior Cruciate Ligament – one of the primary ligaments present in your knee. This ligament is accountable for maintaining the rotational stability of your knee by resisting the motions of internal tibial rotation and anterior tibial translation. Further it is learnt that in its absence degenerative changes , which is seen with aging starts early even in young knees. lots of studies suggest timely ACL surgery prevent such early chances.

Most of the time, while playing games such as soccer, basketball, gymnastics, or downhill skiing, if you make a sudden movement, for instance, you stop abruptly or change the moving direction. In such conditions, the Anterior Cruciate Ligament located in your knee gets torn and results in the medical condition well-known as ACL Injury.

How does an ACL Reconstruction Surgery is performed?

To treat this condition, an ACL Reconstruction surgery is required to perform on your knee to remove this torn ligament and replace it with an appropriated-sized piece of tendon. This tendon may be obtained from other parts of your knee or else from any deceased donor. It is an surgical procedure that incorporates the making of small incisions around the knee joint. You need to consult an orthopedic surgeon who specialized in treating bone/joint associated conditions for this surgery.
However, many orthopedic surgeons with vast knowledge and experience fail in performing an ACL Reconstruction Surgery. It is one of the major concerns that mostly talked about by orthopedic surgeons around the world. But, what leads to an ACL reconstruction failure? Let’s try to understand it in briefly.

What are the causes of an ACL reconstruction failure?

Normally, it mainly occurs due to common surgical mistakes, technical errors, and biological conditions, and acute/chronic traumatisms. However, as opined by many medical experts and surgeons, several other causes are also responsible for it.

Graft Dislocation: Many tunnels will be drilled in the tibia and femur to provide a proper anatomic location for the ACL. Any variations in the positions of these tunnels lengthen the graft and produce abnormal stress. This condition results in impingement of the graft and excessive laxity – both ends in ACL reconstruction failure.

Failure of fixation: The strong fixation option opted to secure placement of the graft offers adequate strength, sufficient stiffness, and great support to avoid inflammatory/degradation issues. However, usage of an improper fixation option can greatly harm the graft and causes cavities in it.

Graft Impingement: Any kind of entrapment in the graft near the intercondylar notch can easily cause ACL reconstruction failure. The prime reasons for this entrapment will be the dislocation of the graft, variations in the shapes and sizes of the notch, as well as graft hypertrophy.

Intrinsic graft failure: The graft failure occurred due to the graft impingement or any trauma might quickly result in ACL reconstruction failure. Also, in many cases associated with the allografts, the low immunologic reaction (body immune system fights to kill the graft) might lead to the graft failure that ultimately results in the complete failure of the ACL reconstruction procedure.

Trauma: Any kind of forceful trauma on the graft in the course of healing or aftermath, can cause harm to a great extent and result in ACL reconstruction failure.

As we understood that, the above-mentioned causes play an important role in ACL reconstruction failure, the orthopedic surgeons required to focus more on these aspects while performing an ACL reconstruction surgery. More attention during the surgical procedures may result in minimized revise ACL reconstruction procedures.
Patient compliance: Not the least, this plays an important factor while rehabilitation after operation. When the patient doesn’t follow the proper post operative muscle strengthening protocol and fails to protect the reconstructed ACL from any afresh injury.

Physiological limitation: When the nature of the joint is so laxed, that the joint goes off shoot its normal range of motion to its extreme. This violates the threshold of the strength of the tissue while it undergoes unusual position and forces.

59 thoughts on “Why did my ACL Reconstruction Surgery Fail?”

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