Failure Rate and Predictors of Failure after Anatomic ACL Reconstruction with Allograft (SS-61)

Eck, Carola Francisca Van; Schkrohowsky, Joshua G.; Ramírez, Claudia; Irrgang, James J.; Fu, Freddie H.; Working, Zachary M

doi:10.1016/j.arthro.2011.03.065

Cited by 3 publications

(7 citation statements)

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“…This could be tremendously useful, especially in light of the higher rates of failure seen in allograft augmentation of the smaller grafts in the younger patient population. 18 , 31 , 33 …”

Section: Discussionmentioning

confidence: 99%

“…Graft size was compared as a continuous interval variable and secondarily grouped into a dichotomous variable to examine small diameter graft sizes (<8 mm) to those larger in diameter (≥8 mm), based on previous literature cutoffs. 3 , 18 , 19 , 31 , 33 This was done to determine whether graft size would ultimately influence outcomes despite the utilization of the STR or whether there would be a deleterious effect of reinforcing these smaller grafts with the STR.…”

Section: Methodsmentioning

confidence: 99%

“…Despite best efforts, anterior cruciate ligament (ACL) injuries remain challenging to treat in the adolescent population in whom graft failure rates remain high relative to adult counterparts. 33 Many of the challenges faced in treating young athletes are nonmodifiable, as research has demonstrated that younger age, associated injury, and smaller graft size are independent risk factors for ACL graft failure. 3 , 15 , 18 , 19 , 31 , 33 Much of the research focus has been placed on determining the best graft choice for these patients.…”

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confidence: 99%

“… 33 Many of the challenges faced in treating young athletes are nonmodifiable, as research has demonstrated that younger age, associated injury, and smaller graft size are independent risk factors for ACL graft failure. 3 , 15 , 18 , 19 , 31 , 33 Much of the research focus has been placed on determining the best graft choice for these patients. The most recent data from large American and Scandinavian registries consisting of thousands of patients have shown that, compared with bone-patellar tendon-bone graft (BTB), hamstring tendon grafts are more likely to require a revision surgery, with a relative risk ratio ranging from 1.4 to 2.3.…”

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confidence: 99%

“… 2 These results are encouraging for the use of graft reinforcement constructs in adolescent patients, in whom soft tissue graft size is often a limiting factor and failure rates are generally higher. 3 , 18 , 19 , 31 , 33 …”

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confidence: 99%

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Outcomes After Hamstring ACL Reconstruction With Suture Tape Reinforcement in Adolescent Athletes

Kitchen

Mitchell

Cognetti

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Previous studies have suggested that suture tape-reinforced anterior cruciate ligament (ACL) grafts may have higher ultimate failure loads without stress-shielding. In patients at high risk for graft failure, such as adolescents, the addition of suture tape could have beneficial outcomes. Hypothesis: Suture tape reinforcement (STR) of ACL grafts in adolescent patients would lead to fewer graft ruptures during early recovery, without hindering subjective outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was performed on adolescent patients with a minimum 2-year follow-up after hamstring tendon autograft ACL reconstruction; enrolled were patients from both before (n = 40) and after (n = 40) a shift in surgical technique that added STR. Both the no-STR and the STR cohorts were contacted yearly to obtain patient-reported outcome data for visual analog scale (VAS; range, 0-10) for pain score, Single Assessment Numeric Evaluation, Lysholm score, Tegner activity score, patient satisfaction score (range, 0-100), and return to previous level of sport (yes/no). The cohorts were then matched based on follow-up duration, excluding those with follow-up of <2 years and >3 years to maintain consistency in duration of follow-up. Graft failure was defined as either graft rupture or recurrent instability symptoms, and failures occurring from index procedure to the 3-year mark were recorded for calculations of failure rate. Results: There were no differences between cohorts in mean age [STR, 15.7 years (range, 9.5-18.7 years); no STR, 14.9 years (range, 9.3-18.8 years)], follow-up duration, laterality, or graft size. While not statistically significant, 2 (5%) patients in the STR cohort experienced graft rupture compared with 7 (17.5%) patients in the no-STR cohort. The Tegner score was significantly higher in the STR cohort ( P = .017); no between-group differences were seen on the other outcome scores. A subanalysis of the STR cohort comparing small-diameter grafts (<8 mm) with grafts ≥8 mm also demonstrated no difference in outcome measures, with 1 graft failure in each cohort. Conclusion: Study outcomes indicated that patients treated with ACL reconstruction and STR experienced a significant improvement in Tegner scores while at the same time maintaining the other subjective outcomes.

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“…This could be tremendously useful, especially in light of the higher rates of failure seen in allograft augmentation of the smaller grafts in the younger patient population. 18 , 31 , 33 …”

Section: Discussionmentioning

confidence: 99%