TY - JOUR
T1 - Allograft versus autograft anterior cruciate ligament reconstruction
T2 - Predictors of failure from a moon prospective longitudinal cohort
AU - Kaeding, Christopher C.
AU - Aros, Brian
AU - Pedroza, Angela
AU - Pifel, Eric
AU - Amendola, Annunziato
AU - Andrish, Jack T.
AU - Dunn, Warren R.
AU - Marx, Robert G.
AU - Mccarty, Eric C.
AU - Parker, Richard D.
AU - Wright, Rick W.
AU - Spindler, Kurt P.
N1 - Funding Information:
The described project was partially funded by grant Nos. 5R01 AR053684 (K.P.S.) and 5K23 AR052392-04 (W.R.D.) from the National Institutes of Health / National Institute of Arthritis and Musculoskeletal and Skin Diseases and the Vanderbilt Sports Medicine Research Fund. Vanderbilt Sports Medicine received unrestricted educational gifts from Smith & Nephew Endoscopy and Aircast. This study was also supported in part by an American Orthopaedic Society for Sports Medicine–Musculoskeletal Transplant Foundation Career Development Award Supplement.
PY - 2011/1
Y1 - 2011/1
N2 - Background: Tearing an anterior cruciate ligament (ACL) graft is a devastating occurrence after ACL reconstruction(ACLR). Identifying and understanding the independent predictors of ACLR graft failure is important for surgical planning,patient counseling, and efforts to decrease the risk of graft failure.Hypothesis: Patient and surgical variables will predict graft failure after ACLR.Study Design: Prospective cohort study.Methods: A multicenter group initiated a cohort study in 2002 to identify predictors of ACLR outcomes, including graft failure.First, to control for confounders, a single surgeon's data (n = 281 ACLRs) were used to develop a multivariable regressionmodel for ACLR graft failure. Evaluated variables were graft type (autograft vs allograft), sex, age, body mass index,activity at index injury, presence of a meniscus tear, and primary versus revision reconstruction. Second, the model was validatedwith the rest of the multicenter study's data (n = 645 ACLRs) to evaluate the generalizability of the model.Results: Patient age and ACL graft type were significant predictors of graft failure for all study surgeons. Patients in the agegroup of 10 to 19 years had the highest percentage of graft failures. The odds of graft rupture with an allograft reconstructionare 4 times higher than those of autograft reconstructions. For each 10-year decrease in age, the odds of graft ruptureincrease 2.3 times.Conclusion: There is an increased risk of ACL graft rupture in patients who have undergone allograft reconstruction.Younger patients also have an increased risk of ACL graft failure.Clinical Relevance: Given these risks for ACL graft rupture, allograft ACLRs should be performed with caution in theyounger patient population.
AB - Background: Tearing an anterior cruciate ligament (ACL) graft is a devastating occurrence after ACL reconstruction(ACLR). Identifying and understanding the independent predictors of ACLR graft failure is important for surgical planning,patient counseling, and efforts to decrease the risk of graft failure.Hypothesis: Patient and surgical variables will predict graft failure after ACLR.Study Design: Prospective cohort study.Methods: A multicenter group initiated a cohort study in 2002 to identify predictors of ACLR outcomes, including graft failure.First, to control for confounders, a single surgeon's data (n = 281 ACLRs) were used to develop a multivariable regressionmodel for ACLR graft failure. Evaluated variables were graft type (autograft vs allograft), sex, age, body mass index,activity at index injury, presence of a meniscus tear, and primary versus revision reconstruction. Second, the model was validatedwith the rest of the multicenter study's data (n = 645 ACLRs) to evaluate the generalizability of the model.Results: Patient age and ACL graft type were significant predictors of graft failure for all study surgeons. Patients in the agegroup of 10 to 19 years had the highest percentage of graft failures. The odds of graft rupture with an allograft reconstructionare 4 times higher than those of autograft reconstructions. For each 10-year decrease in age, the odds of graft ruptureincrease 2.3 times.Conclusion: There is an increased risk of ACL graft rupture in patients who have undergone allograft reconstruction.Younger patients also have an increased risk of ACL graft failure.Clinical Relevance: Given these risks for ACL graft rupture, allograft ACLRs should be performed with caution in theyounger patient population.
KW - Allograft
KW - Anterior cruciate ligament reconstruction
KW - Autograft
KW - Retear
UR - https://www.scopus.com/pages/publications/80051778109
U2 - 10.1177/1941738110386185
DO - 10.1177/1941738110386185
M3 - Article
C2 - 23015994
AN - SCOPUS:80051778109
SN - 1941-7381
VL - 3
SP - 73
EP - 81
JO - Sports Health
JF - Sports Health
IS - 1
ER -