Related Experiment Video
Updated: Oct 16, 2025
Athymic Rat Model for Evaluation of Engineered Anterior Cruciate Ligament Grafts
Published on: March 26, 2015
Post-ACL Reconstruction Graft Failure in Severe Gout Arthritis Patient
Andri Maruli Tua Lubis1, Adisa Yusuf Reksoprodjo1, Mohamad Walid Kuncoro1
1Department of Orthopedic & Traumatology Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Insights
Severe gouty arthritis, though rare, can cause anterior cruciate ligament (ACL) graft failure after reconstruction. This condition leads to joint pain and instability, highlighting a critical, often overlooked, complication.
Area of Science:
- Orthopedic surgery
- Rheumatology
- Sports medicine
Background:
- Pain and instability are common complications following anterior cruciate ligament (ACL) reconstruction.
- Graft failure, infection, inflammation, and mechanical issues are typical causes.
Observation:
- A 36-year-old male presented with pain and swelling six years post-ACL reconstruction.
- Arthroscopic examination revealed a ruptured ACL graft with numerous gout crystals and tophi within the joint.
Findings:
- Gout crystals and tophi were identified as a potential cause of the ACL graft rupture.
- Biological failure, including gouty arthritis, is a recognized etiology of graft failure.
Implications:
- Severe gouty arthritis, while rare, can lead to graft failure in ACL reconstruction.
- This association can cause significant morbidity and joint structure derangement.
Introduction:
Pain and instability following an anterior cruciate ligament (ACL) reconstruction remain a significant issue. Common causes include infection and inflammation, and mechanical issues such as graft failure.
Case Presentation:
A 36-year-old male with an ACL reconstruction six years prior was admitted due to pain and swelling. The ACL graft that had ruptured was found arthroscopically. Numerous gout crystals and tophus were observed inside. This finding is suggested as a cause of this kind of complication.
Discussion:
Biological failure is one of the causes of graft failure. Gout arthritis is associated with internal derangement of the joint structures, which is reported in advanced case.
Conclusion:
Severe gouty arthritis, even though rare, could be an etiology of graft failure following ACL reconstruction and cause significant morbidity.
