Graft Failure in Intra-articular Anterior Cruciate Ligament Reconstructions: a Review of the Literature

There exists a substantial group of patients with unsatisfactory results following anterior cruciate ligament (ACL) reconstructions. This may be attributable to graft failure. Revision surgery, for the correction of abnormal anterior translation of laxity, requires a careful analysis of the causes of failure to ensure the success of the salvage procedure. This review attempts to present an overview of some of the important studies in the literature pertaining to the intraoperative and postoperative factors that probably cause graft failure. It was done by initial identification of the articles from a Medline database followed by the use of cross references. It shows that failures can be minimised by adhering to the correct operative and post-operative techniques wherein proper attention to the factors, such as: adequate notchplasty, proper tunnel placements, proper tensioning, adequate fixation, optimal selection and harvest of the graft, and rehabilitation, are ensured.