Allograft ACL reconstruction had higher revision rate in patients younger than 34 years
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Key takeaways:
- Allograft failure risk decreased in patients at 34 years of age.
- Non-athletes also had decreased allograft failure risk.
NEW ORLEANS — While ACL reconstruction with an allograft was associated with a high risk of revision in younger patients, it may be an acceptable choice for older patients who are not athletes, according to a presenter here.
“We found that the revision risk for allograft ACL reconstruction was significantly higher for patients aged 34 years and younger compared to those aged over 34 years,” Camryn Petit, BS, said in her presentation at the Arthroscopy Association of North America Annual Meeting. “And perhaps most importantly, we found that allograft may be an acceptable graft choice for patients aged over 34 years who do not participate in competitive or recreational athletics.”
Petit and colleagues analyzed receiver operating characteristic analysis and REDCap survey responses from 398 patients who underwent ACL reconstruction with an allograft at Emory Sports Performance and Research Center between 2005 and 2020 (average age, 39 years) to determine rates of secondary ACL injury, as well as the age threshold to safely use an allograft.
“ACL reconstructions are frequently performed in the younger population, with autografts being the preferred graft choice,” Petit said. “However, reduced surgical time and donor-site morbidity for allografts make them warranting consideration.”
Receiver operating characteristic analysis showed the threshold for decreased allograft failure to be 34 years of age for patients, according to Petit. Researchers categorized patients who underwent ACL reconstruction with an allograft into groups based on whether they were 34 years of age and younger or older than 34 years.
Petit noted patients aged 34 years and younger had an increased risk for revision ACL reconstruction and subsequent contralateral ACL injury compared with patients older than 34 years. She added the association was especially pronounced in women aged 34 years and younger.
Researchers also categorized patients based on whether they were competitive or recreational athletes and found higher rates of reinjury for both patients aged younger and those older than 34 years. Petit also noted athletes had a higher risk for reinjury compared with non-athletes.
“However, these differences weren’t significant, most likely due to a small sample size of athletes and an overall low incidence of reinjury,” Petit said.
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Petit C, et al. How young can you safely use allograft for ACL reconstruction? Presented at: Arthroscopy Association of North America Annual Meeting; May 4-6, 2023; New Orleans.
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