Risk of Reinjury or Subsequent Injury After Anterior Cruciate Ligament Reconstruction

Anterior cruciate ligament (ACL) tears are one of the most common injuries seen by orthopaedic surgeons. The standard of care following an ACL tear in a physiologically young, active patient is an ACL reconstruction. This can be accomplished with one of a variety of grafts through a multitude of techniques. With the growing number of ACL tears that are treated with reconstruction, the number of failures, including both graft rerupture and functional instability, is increasing. Reinjury following an ACL reconstruction places a significant physical and physiological burden on the patient, but also creates a societal burden with lost time at work as well as use of health care resources. To better educate patients and to prevent subsequent ACL injuries, it is imperative that orthopaedic surgeons understand the risk factors for reinjury or an injury to the contralateral knee. These include patient-related factors such as age, gender, and activity level, as well as technical considerations such as graft type, size, and position. Furthermore, treating physicians must be able to council patients on ways to avoid a reinjury through rehabilitation, functional sports assessments, and others.