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Hamstring autograft may have higher risk of revision in ACL repair
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Despite being the method of choice for ACL repair in Scandinavia, hamstring autografts were found to have a significantly higher risk of revision than patellar tendon autografts, according to study results.
Researchers culled 45,998 primary ACL reconstructions from the Scandinavian ACL registry for evaluation. Median follow-up time was 3 years. Univariate Kaplan-Meier analyses and Cox proportional hazard regression models were used to compare the risk of revision between patient cohorts. Hazard rate ratios were also recorded.
Autografts of the hamstring were utilized in 14.6% of patients, and patellar tendon autografts were utilized in 84.1% of patients. In the hamstring and patellar tendon autograft cohorts, 66.2% and 67.5% of primary ACL injuries, respectively, stemmed from participation in soccer, team handball or alpine sports. Overall, 1,198 patients underwent revision ACL repair.
The hazard rate was found to be significantly lower in the patellar tendon cohort compared with the hamstring cohort at 0.63. Additionally, the value decreased as the age at surgery increased, although not strictly linearly, according to the researchers.
Factoring in age, sex and concomitant cartilage injury, the only factor that seemed to alter this lower risk of revision in the patellar tendon cohort was involvement in soccer, team handball or alpine sports, according to the researchers.
Patients injured during such activities showed a hazard ratio of 0.57, compared with a 0.81 hazard ratio for those injured by other means.
Disclosure: Engebretsen received grants from Norwegian NIH, Health South East Norway, IOC, FIFA, Norwegian Lottery, Department of Culture Norway, Arthrex, Smith & Nephew, Fin-Ceramica and TBF Tissue Engineering outside the submitted work.
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