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Study finds age, graft size are predictors for re-tear following ACL reconstruction

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COLORADO SPRINGS, Colo. — Results presented at the American Orthopaedic Society for Sports Medicine Annual Meeting showed athletes who underwent ACL reconstruction and were younger than 25 years old and had a graft size of less than 8 mm were at higher risk for re-tear.

Duong Nguyen, MD, FRCSC, MSc, FAAOS, CIME, DipSportsMed (ABOS/CASEM), and colleagues evaluated 503 patients with a mean age of 27.5 years who underwent primary, autograft hamstring ACL reconstruction with the same surgical technique and rehabilitation protocol. Investigators followed the patients for 2 years with return to play allowed within 6 months and 12 months postoperatively. The Lachman, pivot shift exams and MRIs were used to determine ACL graft re-tear.

Duong Nguyen

To determine the predictive value of sex, age and graft size, investigators used multivariate logistic regression. Nguyen and colleagues performed a secondary sensitivity analysis on a subgroup of adolescents, used patient age and graft size as categorical variables and tested for interactions among these variables. The mean graft size used was 7.9 mm.

“If you analyze graft size only, [the] re-tear rate is 0.36-times lower for every unit increase in graft size, so the bigger the better,” Nguyen said during his presentation. “If you analyze sex only, re-tear is 1.8[-times] higher in females, although this is not significant based on this series. If you look at age, the odds of re-tear is 0.86 per unit increase in age. The older [the patient], the less likely of re-tearing. If you put all three factors in combination into multivariate analysis, then age and graft size are significant predictors for re-tears.”

He added, “So we tested our model with multiple statistical tests, and the model is valid.” – by Monica Jaramillo

Reference:

Nguyen D, et al. Paper #111. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 7-10, 2016; Colorado Spring, Colo.

Disclosure: Nguyen reports no relevant financial disclosures.