Several factors linked with graft rupture in young patients after endoscopic ACL reconstruction

Results from this prospective study indicated 15 years after ACL reconstruction in patients aged 18 years and younger, the survival rate was 83% for the ACL graft and 81% for the contralateral ACL. The study also linked family history of graft rupture to a significantly increased risk of graft rupture.

Researchers identified 242 patients aged 18 years and younger who underwent primary ACL reconstruction. Patients completed an interview either via a telephone or a written questionnaire. Investigators used the IKDC subjective knee evaluation form, as well as questions with regard to family history of ACL rupture, subsequent knee injuries and surgeries, whether the patient achieved pre-injury sport levels and current activity levels. Factors considered significant for ACL reconstruction were determined with multivariate regression analysis.

Results showed 75 patients sustained additional ACL injuries during a period of 15 years, including sustained ACL graft ruptures (27 patients), contralateral ACL (CACL) injuries (33 patients) and both ACL rupture and CACL injury (15 patients). The annual graft injury rate was 1.1%.

According to Kaplan-Meier survival analyses, graft survival at 1 year, 2 years, 5 years, 10 years and 15 years was 95%, 92%, 88%, 85% and 83%, respectively. Investigators noted patients with a family history of ACL graft ruptures were at higher risk of sustaining additional ACL injuries compared with those without such a history. CACL survival at 1 year, 2 years, 5 years, 10 years and 15 years was 99%, 98%, 90%, 83% and 81%, respectively. Results from multivariate regression analysis showed male patients and patients who returned to team ball sports correlated with poorer CACL survival. ‒ by Monica Jaramillo

Disclosures: Morgan reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Morgan MD, et al. Am J Sports Med. 2016; doi:10.1177/0363546515623032.