AbstractAlthough most studies have introduced risk factors related to anterior
cruciate ligament reconstruction failure, studies on combinations of
high-risk factors are rare. To provide a systematic review of the risk
factors of anterior cruciate ligament reconstruction failure to guide
surgeons through the decision-making process, an extensive literature search
was performed of the Medline, Embase and Cochrane Library databases. Studies
published between January 1, 2009, and September 19, 2019, regarding the
existing evidence for risk factors of anterior cruciate ligament
reconstruction failure or graft failure were included in this review. Study
quality was evaluated with the quality index. Ultimately, 66 articles met
our criteria. There were 46 cases classified as technical factors, 21 cases
as patient-related risk factors, and 14 cases as status of the knee joint.
Quality assessment scores ranged from 14 to 24. This systematic review
provides a comprehensive summary of the risk factors for anterior cruciate
ligament reconstruction failure, including technical factors,
patient-related factors, and the factors associated with the status of the
knee joint. Emphasis should be placed on avoiding these high-risk
combinations or correcting modifiable risk factors during preoperative
planning to reduce the rate of graft rupture and anterior cruciate ligament
reconstruction failure.