{"id":10046,"date":"2025-08-28T13:13:02","date_gmt":"2025-08-28T13:13:02","guid":{"rendered":"https:\/\/www.centre-ortho.ch\/revision-des-plasties-du-lca-comment-eviter-lechec\/"},"modified":"2025-09-05T08:27:39","modified_gmt":"2025-09-05T08:27:39","slug":"revision-of-acl-plastic-surgery-how-to-avoid-failure","status":"publish","type":"page","link":"https:\/\/www.centre-ortho.ch\/en\/revision-of-acl-plastic-surgery-how-to-avoid-failure\/","title":{"rendered":"ACL Revision: How to Avoid Failure?"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"10046\" class=\"elementor elementor-10046\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6d99501a conteneur_vid_0 e-flex e-con-boxed e-con e-parent\" data-id=\"6d99501a\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-0f6fc3cb conteneur_ariane_vid_0 e-con-full e-flex e-con e-child\" data-id=\"0f6fc3cb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-71251177 e-flex e-con-boxed e-con e-child\" data-id=\"71251177\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-90111f04 ariane_vid_0 elementor-widget elementor-widget-breadcrumbs\" data-id=\"90111f04\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"breadcrumbs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<nav aria-label=\"breadcrumbs\" class=\"rank-math-breadcrumb\"><p><span class=\"last\">Welcome<\/span><\/p><\/nav>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-838d6998 video_vid_1 e-flex e-con-boxed e-con e-child\" data-id=\"838d6998\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4a59b209 video_vid_1 elementor-widget__width-inherit elementor-widget elementor-widget-video\" data-id=\"4a59b209\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/youtu.be\\\/cuw7qdHUXj8&quot;,&quot;lazy_load&quot;:&quot;yes&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ddb4b60c conteneur_principal_vid_0 e-flex e-con-boxed e-con e-parent\" data-id=\"ddb4b60c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-942d898b e-con-full sticky-sidebar colonne_gauche_0 e-flex e-con e-child\" data-id=\"942d898b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-c53cf2e2 e-con-full e-flex e-con e-child\" data-id=\"c53cf2e2\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bcdec876 elementor-widget elementor-widget-shortcode\" data-id=\"bcdec876\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b1233303 e-con-full colonne_vid_0 e-flex e-con e-child\" data-id=\"b1233303\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-749e1940 colonne_vid_1 pv-tv-label aleft elementor-widget-icon-box wgl-icon-box wgl-view-default button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"749e1940\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper wgl-layout-left\"><span class=\"media-wrapper icon-wrapper\"><span class=\"wgl-icon\" ><svg class=\"icon elementor-icon e-font-icon-svg e-fab-youtube\" aria-hidden=\"true\" viewbox=\"0 0 576 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M549.655 124.083c-6.281-23.65-24.787-42.276-48.284-48.597C458.781 64 288 64 288 64S117.22 64 74.629 75.486c-23.497 6.322-42.003 24.947-48.284 48.597-11.412 42.867-11.412 132.305-11.412 132.305s0 89.438 11.412 132.305c6.281 23.65 24.787 41.5 48.284 47.821C117.22 448 288 448 288 448s170.78 0 213.371-11.486c23.497-6.321 42.003-24.171 48.284-47.821 11.412-42.867 11.412-132.305 11.412-132.305s0-89.438-11.412-132.305zm-317.51 213.508V175.185l142.739 81.205-142.739 81.201z\"><\/path><\/svg><\/span><\/span><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Video type:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button no_text no_media\"><div class=\"button__content\"><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3287ba36 colonne_vid_2 pv-tv-value aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"3287ba36\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Presentation of expertise<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d44379f3 e-con-full colonne_vid_0 e-flex e-con e-child\" data-id=\"d44379f3\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-32528b93 colonne_vid_1 aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"32528b93\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Anatomy:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Knee<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9ac8438d colonne_vid_1 aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"9ac8438d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Surgery:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Knee surgery<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d1b601f5 colonne_vid_1 aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"d1b601f5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Pathology:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Anterior cruciate ligament rupture<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-65da5033 colonne_vid_1 aleft button-left elementor-widget elementor-widget-wgl-infobox\" data-id=\"65da5033\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper\"><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h3 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-d587a21\">Thematic:<\/span><\/span><\/h3><\/div><div class=\"wgl-button-wrapper\"><a  class=\"wgl-infobox_button wgl-button  no_media\"><div class=\"button__content\"><span class=\"button__text\">Surgery<\/span><\/div><\/a><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3b46635c e-con-full colonne_vid_0 pv-cta-card e-flex e-con e-child\" data-id=\"3b46635c\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1bb21660 conteneur_spec_vid_6 elementor-widget__width-inherit aleft elementor-widget-icon-box wgl-icon-box elementor-widget elementor-widget-wgl-button\" data-id=\"1bb21660\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button  align-icon-left\" href=\"\/en\/consultation\/\" role=\"button\"><div class=\"button__content\"><span class=\"media-wrapper icon-wrapper\"><span class=\"wgl-icon\" ><svg class=\"icon elementor-icon e-font-icon-svg e-fas-calendar-day\" aria-hidden=\"true\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M0 464c0 26.5 21.5 48 48 48h352c26.5 0 48-21.5 48-48V192H0v272zm64-192c0-8.8 7.2-16 16-16h96c8.8 0 16 7.2 16 16v96c0 8.8-7.2 16-16 16H80c-8.8 0-16-7.2-16-16v-96zM400 64h-48V16c0-8.8-7.2-16-16-16h-32c-8.8 0-16 7.2-16 16v48H160V16c0-8.8-7.2-16-16-16h-32c-8.8 0-16 7.2-16 16v48H48C21.5 64 0 85.5 0 112v48h448v-48c0-26.5-21.5-48-48-48z\"><\/path><\/svg><\/span><\/span><span class=\"button__text\">Consultations<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3d92d979 e-con-full e-flex e-con e-child\" data-id=\"3d92d979\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e46c18bc elementor-widget elementor-widget-shortcode\" data-id=\"e46c18bc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-88a53dad e-con-full conteneur_droit_vid_0 e-flex e-con e-child\" data-id=\"88a53dad\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-865a998e e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"865a998e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b99373ed titre_vid_1 elementor-widget elementor-widget-heading\" data-id=\"b99373ed\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">ACL Revision: How to Avoid Failure?<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-72c483fd paragraphe_vid_1 elementor-widget elementor-widget-text-editor\" data-id=\"72c483fd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>This presentation addresses the causes of anterior cruciate ligament (ACL) reconstruction failure and strategies to improve surgical outcomes. It highlights technical errors, overlooked associated injuries, graft selection criteria, and the importance of a comprehensive knee and patient analysis. A realistic approach with the patient and rigorous rehabilitation are also emphasized.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3c036f95 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"3c036f95\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-de462877 tabs_vid_1 tabs-full-width-yes elementor-widget elementor-widget-wgl-tabs\" data-id=\"de462877\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-tabs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-tabs wgl-tabs_swiper-wrapper tabs_align-justify\">\n            <div class=\"wgl-tabs_headings-wrap swiper\">\n                <div class=\"wgl-tabs_headings swiper-wrapper\"><h4 data-tab-id=\"wgl-tab_3721\" class=\"wgl-tabs_header swiper-slide\">\n                    <span class=\"wgl-tabs_title\">Doctors<\/span>\n\n                    \n                <\/h4><h4 data-tab-id=\"wgl-tab_3722\" class=\"wgl-tabs_header swiper-slide\">\n                    <span class=\"wgl-tabs_title\">Topics<\/span>\n\n                    \n                <\/h4><h4 data-tab-id=\"wgl-tab_3723\" class=\"wgl-tabs_header swiper-slide\">\n                    <span class=\"wgl-tabs_title\">Treatments<\/span>\n\n                    \n                <\/h4><h4 data-tab-id=\"wgl-tab_3724\" class=\"wgl-tabs_header swiper-slide\">\n                    <span class=\"wgl-tabs_title\">Advice<\/span>\n\n                    \n                <\/h4><\/div>\n        <\/div>\n\n        <div class=\"wgl-tabs_content-wrap\">                <div data-tab-id=\"wgl-tab_3721\" class=\"wgl-tabs_content\">\n                    <ul class=\"vireon_dot list_primary_color\"><li class=\"translation-block\"><span><span class=\"word\"><span class=\"target fadeIn\" style=\"--wgl-text-delay: 30ms\">D<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 60ms\">r<\/span><\/span> <span class=\"word\"><span class=\"target fadeIn\" style=\"--wgl-text-delay: 120ms\">E<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 150ms\">r<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 180ms\">i<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 210ms\">c<\/span><\/span> <span class=\"word\"><span class=\"target fadeIn\" style=\"--wgl-text-delay: 270ms\">C<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 300ms\">h<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 330ms\">o<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 360ms\">u<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 390ms\">d<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 420ms\">j<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 450ms\">a<\/span><\/span> <span class=\"word\"><span class=\"target fadeIn\" style=\"--wgl-text-delay: 510ms\">O<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 540ms\">u<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 570ms\">a<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 600ms\">b<\/span><span class=\"target fadeIn\" style=\"--wgl-text-delay: 630ms\">o<\/span><\/span><\/span><\/li><\/ul>                <\/div>\n\n                            <div data-tab-id=\"wgl-tab_3722\" class=\"wgl-tabs_content\">\n                    <ul class=\"vireon_dot list_primary_color\"><li>Frequency of lesions<\/li><li> Unsatisfactory results<\/li><li> Causes of failure<\/li><li> Overall patient analysis<\/li><li> Choice of graft<\/li><\/ul>                <\/div>\n\n                            <div data-tab-id=\"wgl-tab_3723\" class=\"wgl-tabs_content\">\n                    <ul class=\"vireon_check_circle list_primary_color\"><li>Ligament reconstruction<\/li><li> Surgical revision<\/li><li> Osteotomy<\/li><\/ul>                <\/div>\n\n                            <div data-tab-id=\"wgl-tab_3724\" class=\"wgl-tabs_content\">\n                    <ul class=\"vireon_check list_primary_color\"><li>Analyze technical errors<\/li><li> Assess associated lesions<\/li><li> Adapt the choice of graft<\/li><li> Clearly inform the patient<\/li><li> Follow a strict rehabilitation protocol<\/li><\/ul>                <\/div>\n\n                    <\/div>\n        <\/div><!-- .wgl-tabs -->\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ec1267f4 elementor-widget elementor-widget-shortcode\" data-id=\"ec1267f4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-913e6c87 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"913e6c87\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4f75540b titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"4f75540b\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">ACL Revision: Making the Correct Diagnosis of Failure<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-da69e49f elementor-widget elementor-widget-text-editor\" data-id=\"da69e49f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Revision after failed ACL reconstruction requires a comprehensive analysis: tunnel position, graft quality, associated meniscal and capsulo-ligamentous lesions, bone factors (tibial slope, axes), and functional context. Looking &quot;around the box&quot; avoids reducing the problem to the intra-articular graft alone.<br><br>Defining what constitutes failure (instability, pain, inability to return to sport) helps align objectives and strategy.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c2ad0111 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"c2ad0111\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-90524fae titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"90524fae\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Build a realistic strategy<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a081c34b elementor-widget elementor-widget-text-editor\" data-id=\"a081c34b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Clearly informing the patient about the expected results and risks is essential, especially since revision surgeries offer, on average, inferior results to primary surgeries. Depending on the case, a one- or two-stage procedure is discussed, particularly if the tunnels are enlarged or poorly positioned, or if associated procedures (meniscus, anterolateral, axis correction) are necessary.<br><br>The choice of graft (quadriceps, patellar, hamstring) takes into account the history and mechanical needs.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e43685ee e-con-full conteneur_citation_vid_0 e-flex e-con e-child\" data-id=\"e43685ee\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-69165e82 conteneur_citation_vid_1 aleft elementor-widget-icon-box wgl-icon-box wgl-view-default elementor-widget elementor-widget-wgl-infobox\" data-id=\"69165e82\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper wgl-layout-left\"><span class=\"media-wrapper icon-wrapper\"><span class=\"wgl-icon\" ><svg class=\"icon elementor-icon e-font-icon-svg e-fas-quote-left\" aria-hidden=\"true\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M464 256h-80v-64c0-35.3 28.7-64 64-64h8c13.3 0 24-10.7 24-24V56c0-13.3-10.7-24-24-24h-8c-88.4 0-160 71.6-160 160v240c0 26.5 21.5 48 48 48h128c26.5 0 48-21.5 48-48V304c0-26.5-21.5-48-48-48zm-288 0H96v-64c0-35.3 28.7-64 64-64h8c13.3 0 24-10.7 24-24V56c0-13.3-10.7-24-24-24h-8C71.6 32 0 103.6 0 192v240c0 26.5 21.5 48 48 48h128c26.5 0 48-21.5 48-48V304c0-26.5-21.5-48-48-48z\"><\/path><\/svg><\/span><\/span><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h5 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-56c0705\">We need to stop looking in the box and look around the box.<\/span><\/span><\/h5><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-31b25843 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"31b25843\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6ae79cfb titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"6ae79cfb\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Controlling recidivism factors<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-89669321 elementor-widget elementor-widget-text-editor\" data-id=\"89669321\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>A high tibial slope increases anterior translation and stresses the graft; measuring it systematically helps adapt the treatment. Secondary stability (menisci, lateral structures) must be assessed and treated to limit pivot-shift and secure the reconstruction.<br><br>Every decision aims to create a mechanical environment favorable to the longevity of the graft.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3ae9a0eb e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"3ae9a0eb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-af25f614 titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"af25f614\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Rehabilitation and success criteria<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-965eff0b elementor-widget elementor-widget-text-editor\" data-id=\"965eff0b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The rehabilitation protocol is strict and progressive, with objective milestones before each stage of recovery. Success is not limited to a \u201cnormal\u201d MRI, but is measured by stability, function, and return to target activities.<br><br>Close monitoring allows loads and exercises to be adjusted to prevent overstressing.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4b0eed93 e-con-full conteneur_citation_vid_0 e-flex e-con e-child\" data-id=\"4b0eed93\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b8b521c6 conteneur_citation_vid_1 aleft elementor-widget-icon-box wgl-icon-box wgl-view-default elementor-widget elementor-widget-wgl-infobox\" data-id=\"b8b521c6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wgl-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wgl-infobox_bg_wrapper\"><\/div><div class=\"wgl-infobox\"><div class=\"wgl-infobox_wrapper wgl-layout-left\"><span class=\"media-wrapper icon-wrapper\"><span class=\"wgl-icon\" ><svg class=\"icon elementor-icon e-font-icon-svg e-fas-quote-left\" aria-hidden=\"true\" viewbox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M464 256h-80v-64c0-35.3 28.7-64 64-64h8c13.3 0 24-10.7 24-24V56c0-13.3-10.7-24-24-24h-8c-88.4 0-160 71.6-160 160v240c0 26.5 21.5 48 48 48h128c26.5 0 48-21.5 48-48V304c0-26.5-21.5-48-48-48zm-288 0H96v-64c0-35.3 28.7-64 64-64h8c13.3 0 24-10.7 24-24V56c0-13.3-10.7-24-24-24h-8C71.6 32 0 103.6 0 192v240c0 26.5 21.5 48 48 48h128c26.5 0 48-21.5 48-48V304c0-26.5-21.5-48-48-48z\"><\/path><\/svg><\/span><\/span><div class=\"content_wrapper\"><div class=\"wgl-infobox-title_wrapper\"><h5 class=\"wgl-infobox_title\"><span class=\"wgl-infobox_title-idle\"><span class=\"elementor-repeater-item-56c0705\">In the first ACL reconstruction, do your best surgery, choose the best graft.<\/span><\/span><\/h5><\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5721add0 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"5721add0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8a9edc28 titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"8a9edc28\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">When to postpone or stagger the revision?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b4028119 elementor-widget elementor-widget-text-editor\" data-id=\"b4028119\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Tunnels that are too wide, infection, or marked axis defects may lead to a two-stage strategy, with reconstruction delayed after bone preparation or prior correction. This caution improves final stability and reduces the risk of repeated failure.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d22796e0 e-con-full conteneur_vid_1 e-flex e-con e-child\" data-id=\"d22796e0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f0fb5ccb titre_vid_2 elementor-widget elementor-widget-heading\" data-id=\"f0fb5ccb\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Breadcrumbs<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0daefbe7 elementor-widget elementor-widget-text-editor\" data-id=\"0daefbe7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Analyze, correct, stabilize. Successful revision relies on a comprehensive assessment of the knee and a transparent treatment plan, shared with the patient and their care team.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f0994585 e-con-full conteneur_tags_0 e-flex e-con e-child\" data-id=\"f0994585\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f318895d conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"f318895d\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/anterior-cruciate-ligament\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">anterior cruciate ligament<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-786caebc conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"786caebc\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/lca\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">LCA<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eff57dc8 conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"eff57dc8\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/plastic-surgery\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">plastic surgery<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c20af544 conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"c20af544\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/revision\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">revision<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-080d1a3c conteneur_tags_1 aleft elementor-widget elementor-widget-wgl-button\" data-id=\"080d1a3c\" data-element_type=\"widget\" data-e-type=\"widget\" style=\"\" data-widget_type=\"wgl-button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"wgl-button\" href=\"https:\/\/www.centre-ortho.ch\/en\/research\/knee-surgery-2\/\" role=\"button\"><div class=\"button__content\"><span class=\"button__text\">knee surgery<\/span><\/div><\/a>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1ad4738b e-con-full e-flex e-con e-parent\" data-id=\"1ad4738b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cc125dc5 elementor-widget elementor-widget-shortcode\" data-id=\"cc125dc5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b568feab e-con-full e-flex e-con e-parent\" data-id=\"b568feab\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-dfac4c9b elementor-widget elementor-widget-shortcode\" data-id=\"dfac4c9b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e7603802 e-con-full e-flex e-con e-parent\" data-id=\"e7603802\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-80b5841b elementor-widget elementor-widget-shortcode\" data-id=\"80b5841b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Cette pr\u00e9sentation aborde les causes d\u2019\u00e9chec des plasties du ligament crois\u00e9 ant\u00e9rieur (LCA) et les strat\u00e9gies pour am\u00e9liorer les r\u00e9sultats chirurgicaux. Elle met en lumi\u00e8re les erreurs techniques, les l\u00e9sions associ\u00e9es n\u00e9glig\u00e9es, les crit\u00e8res de choix de greffe et l\u2019importance d\u2019une analyse compl\u00e8te du genou et du patient.<\/p>","protected":false},"author":1,"featured_media":14997,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[76],"tags":[180,172,198,362,363],"class_list":["post-10046","page","type-page","status-publish","has-post-thumbnail","hentry","category-videos","tag-chirurgie-genou","tag-lca","tag-ligament-croise-anterieur","tag-plastie","tag-revision"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/pages\/10046","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/comments?post=10046"}],"version-history":[{"count":0,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/pages\/10046\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/media\/14997"}],"wp:attachment":[{"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/media?parent=10046"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/categories?post=10046"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.centre-ortho.ch\/en\/wp-json\/wp\/v2\/tags?post=10046"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}