title: Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction: Predictors of Failure From a MOON Prospective Longitudinal Cohort.
abstract: 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.
  
  
  OBJECTIVE
  Patient and surgical variables will predict graft failure after ACLR.
  
  
  METHODS
  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 regression model 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 validated with 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 age group of 10 to 19 years had the highest percentage of graft failures. The odds of graft rupture with an allograft reconstruction are 4 times higher than those of autograft reconstructions. For each 10-year decrease in age, the odds of graft rupture increase 2.3 times.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  Given these risks for ACL graft rupture, allograft ACLRs should be performed with caution in the younger patient population.
authors.affiliation: Department of Orthopaedics, The Ohio State University School of Medicine, Columbus, Ohio.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Kaeding
authors.forename: Brian
authors.initials: B
authors.lastname: Aros
authors.forename: Angela
authors.initials: A
authors.lastname: Pedroza
authors.forename: Eric
authors.initials: E
authors.lastname: Pifel
authors.forename: Annunziato
authors.initials: A
authors.lastname: Amendola
authors.forename: Jack T
authors.initials: JT
authors.lastname: Andrish
authors.forename: Warren R
authors.initials: WR
authors.lastname: Dunn
authors.forename: Robert G
authors.initials: RG
authors.lastname: Marx
authors.forename: Eric C
authors.initials: EC
authors.lastname: McCarty
authors.forename: Richard D
authors.initials: RD
authors.lastname: Parker
authors.forename: Rick W
authors.initials: RW
authors.lastname: Wright
authors.forename: Kurt P
authors.initials: KP
authors.lastname: Spindler