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Anterior cruciate ligament reconstruction failure and revision surgery: current concepts
  1. Santiago Pache1,2,
  2. Juan Del Castillo3,4,
  3. Gilbert Moatshe5,6,
  4. Robert F LaPrade7
  1. 1 Orthopedic Surgery, Dirección Nacional de Sanidad de las Fuerzas Armadas, Montevideo, Uruguay
  2. 2 Orthopedic Department, Centro Asistencial del Sindicato Médico del Uruguay (Casmu), Montevideo, Uruguay
  3. 3 Clínica de Traumatología y Ortopedia, Universidad de la República Uruguay, Montevideo, Uruguay
  4. 4 Traumatología y Ortopedia, Banco de Seguros del Estado, Montevideo, Uruguay
  5. 5 Orthopaedic Surgery, Sports Medicine, Oslo Sports Trauma Research Center, Oslo, Norway
  6. 6 Orthopedic Department, Oslo University Hospital, Oslo, Norway
  7. 7 Orthopedic Department, Twin Cities Orthopedics, Edina, Minnesota, USA
  1. Correspondence to Dr Santiago Pache, Orthopedic Department, Dirección Nacional de Sanidad de las Fuerzas Armadas, Montevideo 11600, Uruguay; santiagopache{at}


Anterior cruciate ligament reconstruction (ACLR) is one of the most commonly performed procedures in orthopaedic sports medicine. Despite developments in understanding the anatomy and biomechanics of the knee joint, a fairly large subset of patients has ACLR failure. Outcomes after revision ACLR are historically inferior to primary ACLR. Thus, a systematic approach is necessary to identify all potential causes of failure and addressing them in conjunction with a revision ACLR to mitigate the risk of revision failure and to maximise improved patient outcomes.

  • anterior cruciate ligament
  • knee injuries
  • ligaments
  • joint instability
  • sports medicine

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  • Contributors SP: planning and writing the manuscript. JDC: planning and writing the manuscript. GM: planning, writing and editing the manuscript. RL: planning, writing, editing and conducting of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests RL is Consultant for Arthrex, Ossur, Smith and Nephew and Linvatec. Receives royalties from Arthrex, Ossur and Smith and Nephew. Grants from Ossur and Smith and Nephew. Editorial boards of AJSM, KSSTA and JEO.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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