{"title":"Anterior Cruciate Ligament Reconstruction: Common Intraoperative Mistakes and Techniques for Error Recovery.","authors":"Kevin C Wang, Timothy Keeley, Drew A Lansdown","doi":"10.1007/s12178-025-09947-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure among general orthopedists, and is a logged procedure required for graduation from accredited orthopaedic residency programs.</p><p><strong>Recent findings: </strong>ACL reconstruction surgery has a number of critical steps, and intraoperative errors can significantly impact the success rate and morbidity of this operation. Technical errors are frequently cited as some of the most common reasons for ACL reconstruction failure. This narrative review provides low-volume surgeons and trainees with an overview of the common errors that can be made during the critical steps of an ACL reconstruction procedure. We suggest technical points for avoiding commonly-encountered errors and provide a description of evidence-supported error recovery techniques to address these errors if they occur intraoperatively. These key steps include femoral tunnel creation, tibial tunnel creation, graft harvest and preparation, and graft fixation within the tunnels. We discuss a number of primary and backup fixation strategies as well as all commonly used autografts (bone-patellar tendon-bone, hamstring, and quadriceps tendon). Additionally, we provide a brief overview on address intra-operative graft contamination citing currently available evidence.</p>","PeriodicalId":10950,"journal":{"name":"Current Reviews in Musculoskeletal Medicine","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Reviews in Musculoskeletal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12178-025-09947-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Anterior Cruciate Ligament Reconstruction: Common Intraoperative Mistakes and Techniques for Error Recovery.
Purpose of review: Anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure among general orthopedists, and is a logged procedure required for graduation from accredited orthopaedic residency programs.
Recent findings: ACL reconstruction surgery has a number of critical steps, and intraoperative errors can significantly impact the success rate and morbidity of this operation. Technical errors are frequently cited as some of the most common reasons for ACL reconstruction failure. This narrative review provides low-volume surgeons and trainees with an overview of the common errors that can be made during the critical steps of an ACL reconstruction procedure. We suggest technical points for avoiding commonly-encountered errors and provide a description of evidence-supported error recovery techniques to address these errors if they occur intraoperatively. These key steps include femoral tunnel creation, tibial tunnel creation, graft harvest and preparation, and graft fixation within the tunnels. We discuss a number of primary and backup fixation strategies as well as all commonly used autografts (bone-patellar tendon-bone, hamstring, and quadriceps tendon). Additionally, we provide a brief overview on address intra-operative graft contamination citing currently available evidence.
期刊介绍：
This journal intends to review the most significant recent developments in the field of musculoskeletal medicine. By providing clear, insightful, balanced contributions by expert world-renowned authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of musculoskeletal-related conditions.
We accomplish this aim by appointing authorities to serve as Section Editors in key subject areas, such as rehabilitation of the knee and hip, sports medicine, trauma, pediatrics, health policy, customization in arthroplasty, and rheumatology. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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