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Young patients at increased risk of graft rupture, contralateral injury after ACL repair
Patients less than 20 years old are at a higher risk for graft rupture and contralateral ACL injury hollowing ACL reconstruction, according to recently published data.
Kate E. Webster, PhD, and colleagues at La Trobe University in Australia studied 561 patients who underwent primary ACL reconstruction with a minimum 3-year follow-up for incidence of ACL graft rupture, contralateral ACL injury, family history of ACL injury and current activity level. Age, gender, original injury mechanism, meniscus or articular surface injury, and graft diameter was also analyzed.
At a mean of 80 weeks postoperatively, 25 patients had ACL graft ruptures and 42 patients had contralateral ACL injuries. The highest incidence of additional ACL injury occurred in patients who were younger than 20 years at the time of surgery, as this 29% of this group of patients had a subsequent ACL injury to either knee.
The return to cutting and pivoting sports activity increased the odds of graft rupture and contralateral rupture by factors of 3.9 and 5, respectively. Overall, 88% of the less than age 20 years returned to such activities compared with 53% of patients older than 20 years. Positive family history doubled the odds for both graft rupture and contralateral ACL injury.
“This high reinjury rate is of concern and has implications for the preoperative advice that is given to younger patients regarding the risk of further injury after ACL reconstruction and postoperative management,” Webster and colleagues concluded. — by Christian Ingram
Disclosure: The study was partly funded by a Perpetual I8 grant.