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Young patient age, use of allograft tissue may increase odds of failed ipsilateral ACL reconstruction
There was an association found in this study between ipsilateral ACL graft failure and patients who were young, patients with higher activity levels and patients who were reconstructed with ACL allograft.
Researchers identified risk factors for ACL retear using data from the Multicenter Orthopaedic Outcomes Network and included 2,683 patients with primary ACL reconstruction in the study. Patients had no history of contralateral knee surgery and 2-year follow-up data, minimum. To determine the contribution to both ipsilateral retear and contralateral ACL tear, researchers evaluated the patients by age, sex, Marx activity score, graft type, smoking status, lateral meniscal tear, medial meniscal tear, sport played at index injury and surgical facility.
Christopher Kaeding
According to the results, 4.4% of patients experienced ipsilateral graft tears and 3.5% of patients experienced contralateral ACL tears. Compared with bone-patellar tendon-bone (BTB) autograft, researchers found allograft had a 5.2 times greater odds of ipsilateral ACL retear. However, there were no significant differences in odds of retear between BTB autograft and hamstring autograft. For every yearly increase in patient age, the odds of ipsilateral ACL retear decreased 0.09, while the odds of retear increased 0.11 for every increased point on the Marx score, based on the results.
In addition, researchers noted that sex, smoking status, sport played, medial or lateral meniscal tear or consortium site did not significantly influence the odds of a retear. For contralateral ACL tears, the odds decreased 0.04 for every yearly increase in patient age and it increased 0.12 for every increased point on the Marx score. – by Casey Tingle
Disclosure: Kaeding reports he received partial support from Smith & Nephew, DonJoy Orthopaedics and Vanderbilt Orthopaedics.