title: Reconstruction of the anterior cruciate ligament: association of graft choice with increased risk of early revision.
abstract: We examined the association of graft type with the risk of early revision of primary anterior cruciate ligament reconstruction (ACLR) in a community-based sample. A retrospective analysis of a cohort of 9817 ACLRs recorded in an ACLR Registry was performed. Patients were included if they underwent primary ACLR with bone-patellar tendon-bone autograft, hamstring tendon autograft or allograft tissue. Aseptic failure was the main endpoint of the study. After adjusting for age, gender, ethnicity, and body mass index, allografts had a 3.02 times (95% confidence interval (CI) 1.93 to 4.72) higher risk of aseptic revision than bone-patellar tendon-bone autografts (p < 0.001). Hamstring tendon autografts had a 1.82 times (95% CI 1.10 to 3.00) higher risk of revision compared with bone-patellar tendon-bone autografts (p = 0.019). For each year increase in age, the risk of revision decreased by 7% (95% CI 5 to 9). In gender-specific analyses a 2.26 times (95% CI 1.15 to 4.44) increased risk of hamstring tendon autograft revision in females was observed compared with bone-patellar tendon-bone autograft. We conclude that allograft tissue, hamstring tendon autografts, and younger age may all increase the risk of early revision surgery after ACLR.
authors: Kaiser Permanente, San Diego, California, USA. gregory.b.maletis@kp.org
authors: G B
authors: GB
authors: Maletis
authors: M C S
authors: MC
authors: Inacio
authors: J L
authors: JL
authors: Desmond
authors: T T
authors: TT
authors: Funahashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D050376:Bone-Patellar Tendon-Bone Grafting; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D055815:Young Adult