COMMON CAUSES OF FAILURE IN ACL RECONSTRUCTION AND ITS MANAGEMENT – A PROSPECTIVE STUDY

Introduction: Knee stability can be restored via the anterior cruciate ligament (ACL) reconstruction surgery that is the most important surgical treatment option for athletes who experience an ACL injury. Although surgical techniques to reconstruct an ACL have signicantly improved, failure rates of this surgery continues to be a grave problem for patients, resulting in knee instability and extended recovery time. The aim of this study is to select the chief causes of failure of ACL reconstruction and assess methods of changing such causes with the intention of augmenting improved patient outcomes. Methods And Methodology: Twenty four patients who had failed primary ACL reconstruction in which failure was dened as anterior translation of more than 15 mm were included in the study as a retrospective review. The study period was from 2022 to 2024; patients were selected using inclusion criteria consisting of a history of ACL reconstruction, being complainant of knee instability, pain, or stiffness with Lachman and/or pivot shift tests positive. Data was collected clinically with examination, radiographically with imaging, and surgically with records. Results: The most commonly observed causes for failure of ACL reconstruction were infection (60%), technical error (30%), graft failure (5%) and patient noncompliance (5%). Management strategies had been arthroscopic lavage and debridement for infection, proper selection of graft (autografts or allografts), arthroscopic revision ATG utilizing a single or two stage strategy dependant on diploma of technical errors and arthroscopic removal of graft and placement of new graft (with or without tension band wire). Conclusion: Overall, the ndings emphasize the need for accurate surgical technique, a suitable graft, and aggressive postoperative rehabilitation in order to lessen the chances of failure after ACL reconstruction. It shows more preoperative planning is required along with involving of preventative measures such as antibiotic graft soaking is essential as well as educations of patients to decrease the failure rates and improve surgical outcomes.