Evidence map›Paper›PMID 38586217›Full record

ReviewOpen access journal of sports medicine2024

Evaluation of Failed ACL Reconstruction: An Updated Review.

Bryson Kemler, Carlo Coladonato, John Hayden Sonnier, Michael P Campbell, Danielle Darius, Brandon J Erickson, Fotios Paul Tjoumakaris, Kevin B Freedman

Abstract readReview
In one paragraph

Review in Open access journal of sports medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
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  5. [Mechanisms and applications of magnesium ion-regulated stem cell functions in promoting tendon-bone interface healing].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2026
    Review
  6. Article
  7. Review
  8. Article
  9. Beyond the ACL: The Hidden Impact of Ramp Tears on Knee Stability.The archives of bone and joint surgery · 2026
    Review
  10. Second revision of anterior cruciate ligament reconstruction using achilles tendon allograft: a case series of 20 patients at mid-term follow-up.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Bryson KemlerDepartment of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA, USA.
Carlo ColadonatoDepartment of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA, USA.
John Hayden SonnierDepartment of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA, USA.ORCID 0000-0002-6748-261X
Michael P CampbellDepartment of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA, USA.ORCID 0000-0001-9206-317X
Danielle DariusDepartment of Education, Drexel University College of Medicine, Philadelphia, PA, USA.ORCID 0000-0002-4740-4278
Brandon J EricksonDepartment of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA, USA.
Fotios Paul TjoumakarisDepartment of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA, USA.
Kevin B FreedmanDepartment of Orthopaedic Surgery, Rothman Institute, Philadelphia, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Failure rates among primary Anterior Cruciate Ligament Reconstruction (ACLR) range from 3.2% to 11.1%. Recently, there has been increased focus on surgical and anatomic considerations which predispose patients to failure, including excessive posterior tibial slope (PTS), unaddressed high-grade pivot shift, and improper tunnel placement. The purpose of this review was to provide a current summary and analysis of the literature regarding patient-related and technical factors surrounding revision ACLR, rehabilitation considerations, overall outcomes and return to sport (RTS) for patients who undergo revision ACLR. There is a convincingly higher re-tear and revision rate in patients who undergo ACLR with allograft than autograft, especially amongst the young, athletic population. Unrecognized Posterior Cruciate Ligament (PLC) injury is a common cause of ACLR failure and current literature suggests concurrent operative management of high-grade PLC injuries. Given the high rates of revision surgery in young active patients who return to pivoting sports, the authors recommend strong consideration of a combined ACLR + Anterolateral Ligament (ALL) or Lateral extra-articular tenodesis (LET) procedure in this population. Excessive PTS has been identified as an independent risk factor for ACL graft failure. Careful consideration of patient-specific factors such as age and activity level may influence the success of ACL reconstruction. Additional technical considerations including graft choice and fixation method, tunnel position, evaluation of concomitant posterolateral corner and high-grade pivot shift injuries, and the role of excessive posterior tibial slope may play a significant role in preventing failure.

Indexed as

ACLanterior cruciate ligamentanterior cruciate ligament reconstructionfailed ACL graftposterior tibial sloperevision ACL reconstruction

Identifiers

PMID38586217
PMCPMC10998505

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.