RT Journal
A1 Wright, Rick W.
A1 Magnussen, Robert A.
A1 Dunn, Warren R.
A1 Spindler, Kurt P.
T1 Ipsilateral Graft and Contralateral ACL Rupture at Five Years or More Following ACL ReconstructionA Systematic Review
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD June 15
VO 93
IS 12
SP 1159
OP 1165
DO 10.2106/JBJS.J.00898
UL http://dx.doi.org/10.2106/JBJS.J.00898
AB Background: 
  Injury to the ipsilateral graft used for reconstruction of the anterior cruciate ligament (ACL) or a new injury to the contralateral ACL is a devastating outcome following successful ACL reconstruction, rehabilitation, and return to sport. Little evidence exists regarding the intermediate to long-term risk of these events.Methods: 
  The present study is a systematic review of Level-I and II prospective studies that evaluated the rate of rupture of the ACL graft and the ACL in the contralateral knee following a primary ACL reconstruction with use of a mini-open or arthroscopic bone-tendon-bone or hamstring autograft after a minimum duration of follow-up of five years.Results: 
  Six studies met the inclusion and exclusion criteria. The ipsilateral ACL graft rupture rate ranged from 1.8% to 10.4%, with a pooled percentage of 5.8%. The contralateral injury rate ranged from 8.2% to 16.0%, with a pooled percentage of 11.8%.Conclusions: 
  This systematic review demonstrates that the risk of ACL tear in the contralateral knee (11.8%) is double the risk of ACL graft rupture in the ipsilateral knee (5.8%). Additional studies must be performed to determine predictors for these injuries and to improve our ability to avoid this devastating outcome.Level of Evidence: 
  Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.