前交叉韧带重建失败究竟意味着什么？一个综合视角
简介
这篇叙述性综述系统分析了前交叉韧带重建（ACLR）术后“失败”定义的异质性，指出当前文献中基于移植物断裂、翻修手术、松弛度阈值或患者报告症状的单一标准均存在局限。作者提出一个整合性定义，将客观或主观不稳定、持续性膝痛、关节活动度受限、移植物断裂及新发症状性半月板损伤均纳入失败范畴，旨在为临床评估和标准化报告提供多维度、以患者为中心的框架。
英文摘要
Anterior cruciate ligament reconstruction (ACLR) is among the most frequently performed and successful procedures in orthopedic surgery. Nevertheless, a substantial proportion of patients experience postoperative "failure," a term that remains inconsistently defined throughout the literature. This narrative review critically analyzes the heterogeneity of definitions applied to ACLR failure, underscoring persistent gaps, contradictions, and their implications for clinical practice and research. We subsequently propose an integrative definition that aligns with both the clinical and functional objectives of reconstruction. Failure may result from multiple factors, including but not limited to technical, biological, traumatic, and patient-related, and inconsistencies arise when definitions rely exclusively on graft rupture, revision surgery, laxity thresholds, or isolated patient-reported symptoms. Although current consensus statements acknowledge this variability, they fail to provide operational definitions. Consequently, reported failure rates vary considerably, limiting comparability across studies. We advocate defining ACLR failure, as the presence of any of the following: objective or subjective post-operative instability, persistent knee pain, functional limitation including restricted range of motion, documented graft rupture, or new symptomatic meniscal injury in the absence of significant trauma. This multidimensional, patient-centered framework reflects the fundamental goals of ACLR and may serve as a foundation for standardized reporting criteria in future clinical and research endeavors.