Knee Ligament Injuries
A 28-year-old male athlete presents 18 months after ACL reconstruction with patellar tendon autograft with recurrent instability. He reports a re-injury during a pivoting maneuver in basketball. Examination reveals positive Lachman test (grade 2, soft endpoint) and positive pivot shift. X-rays show the femoral tunnel positioned anteriorly at the 11 o'clock position (right knee). CT scan confirms femoral tunnel malposition with tunnel widening. The surgeon discusses the causes of graft failure, options for revision surgery including graft choice, and whether staged reconstruction with bone grafting is required. Regarding ACL graft failure and revision reconstruction:
Mark each as TRUE or FALSE
TECHNICAL ERROR is the most common cause of ACL graft failure (50-80%), with FEMORAL TUNNEL MALPOSIT...
Revision ACL reconstruction has LOWER success rates than primary (75-85% vs 90-95%); risk factors fo...
Technical error is RARE (5%) and traumatic re-injury is the main cause (90%); revision surgery has H...
GRAFT CHOICE in revision: CONTRALATERAL BTB or hamstring AUTOGRAFT is preferred for young active pat...
STAGED reconstruction (bone grafting then revision 3-6 months later) is required when tunnel widenin...
Answer the questions to see explanations
Click T (True) or F (False) for each option