Determining The Rate Of Ipsilateral And Contralateral ACL Rupture Following ACL Reconstruction Surgery In Males And Females: A Systematic Review

Abstract

Introduction: The ACL is one of the two intraarticular ligaments within the knee joint that provides stabilization and resists against anterior translation of the tibia on the femur and rotation. There are many risk factors that may predispose an athlete to an ACL tear or increase their risks, however excessive motion at any plane may cause an ACL rupture. Over the last decade, several research studies have found that the rate of ACL tears following reconstruction surgery has increased compared to previous decades. Objective: The primary objective of this systematic review was to determine the rate of ipsilateral and contralateral ACL ruptures following ACL reconstruction surgery in both males in females. Background: A literature search was performed using PubMed, Medline, Academic Search Premier, and CINAHL databases. Twelve articles met inclusion criteria and minimum score on the Modified Downs and Black for Study Quality checklist. All articles included in this systematic review include findings on the incidence of rupture rates on both the ipsilateral and contralateral ACL tears including percentages within the last 12 years and included both males and females within their study design. Results: Comparison of twelve studies included 6,901 post-operative ACL reconstruction patients, 57% male and 43% female. Patients were followed for an average of 6.9 years, with a follow-up windows ranging from 1 year to 15 years. The ipsilateral ACL re-rupture rate was 6.07% and contralateral ACL re-rupture rate was 6.89%. Overall rate of re-rupture following ACL reconstruction is 12.97% with a range of 5.96% to 35.8%. Conclusion: Post-operative ACL reconstruction patients have nearly a 13% risk of sustaining another ACL injury. Studies that followed patients for longer period of time reported higher injury rates comparatively. The research suggests that patients are more likely to tear their contralateral ACL compared to the ipsilateral following ACL reconstruction. Future longitudinal studies are needed to further examine risk of rupturing the ipsilateral or contralateral ACL following an ipsilateral reconstruction surgery, as well as, investigating possible risk factors for re-rupturing the ACL.