Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft.
OBJECTIVE
To evaluate whether decreased hamstring autograft size and decreased patient age are predictors of early graft revision.


METHODS
Of 338 consecutive patients undergoing primary anterior cruciate ligament (ACL) reconstruction with hamstring autograft, 256 (75.7%) were evaluated. Graft size and patient age, gender, and body mass index at the time of ACL reconstruction were recorded, along with whether subsequent ACL revision was performed.


RESULTS
The 256 patients comprised 136 male and 120 female patients and ranged in age from 11 to 52 years (mean, 25.0 years). The mean follow-up was 14 months (range, 6 to 47 months). Revision ACL reconstruction was performed in 18 of 256 patients (7.0%) at a mean of 12 months after surgery (range, 3 to 31 months). Revision was performed in 1 of 58 patients (1.7%) with grafts greater than 8 mm in diameter, 9 of 139 patients (6.5%) with 7.5- or 8-mm-diameter grafts, and 8 of 59 patients (13.6%) with grafts 7 mm or less in diameter (P = .027). There was 1 revision performed in the 137 patients aged 20 years or older (0.7%), but 17 revisions were performed in the 119 patients aged under 20 years (14.3%) (P < .0001). Most revisions (16 of 18) were noted to occur in patients aged under 20 years with grafts 8 mm in diameter or less, and the revision rate in this population was 16.4% (16 of 97 patients). Age less than 20 years at reconstruction (odds ratio [OR], 18.97; 95% confidence interval [CI], 2.43 to 147.06; P = .005), decreased graft size (OR, 2.20; 95% CI, 1.00 to 4.85; P = .05), and increased follow-up time (OR, 1.07; 95% CI, 1.02 to 1.12) were associated with increased risk of revision.


CONCLUSIONS
Decreased hamstring autograft size and decreased patient age are predictors of early graft revision. Use of hamstring autografts 8 mm in diameter or less in patients aged under 20 years is associated with higher revision rates.


METHODS
Level III, retrospective comparative study.
Department of Orthopaedic Surgery, The Ohio State University School of Medicine, Columbus, Ohio, USA. robert.magnussen@gmail.com
Robert A
RA
Magnussen
J Todd R
JT
Lawrence
Ryenn L
RL
West
Alison P
AP
Toth
Dean C
DC
Taylor
William E
WE
Garrett
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007717:Knee; D007718:Knee Injuries / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013710:Tendons / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult