title: Return to Play of Rugby Players After Anterior Cruciate Ligament Reconstruction Using Hamstring Autograft: Return to Sports and Graft Failure According to Age.
abstract: OBJECTIVE
  To assess return to play and the frequencies of graft failure in rugby players after anterior cruciate ligament (ACL) reconstruction using a hamstring autograft augmented with an artificial ligament and to compare outcomes between rugby players aged <20 and ≥20 years over the long term.
  
  
  METHODS
  A consecutive series of 146 rugby players who underwent ACL reconstruction with a hamstring autograft augmented with an artificial ligament were retrospectively reviewed. The study population was further divided into 2 groups aged <20 years and >20 years and compared.
  
  
  RESULTS
  Twenty-five patients could not be followed up, and 121 (83%) were evaluated. Most patients (90%, <20 years; 92%, ≥20 years) returned to play after ACL reconstruction. At an average follow-up period of 56.5 months, 16% of the patients sustained an ACL graft rupture. Regarding age, <20 years (n = 58, 48%) and ≥20 years (n = 63, 52%), younger players had a significantly higher failure rate (23% vs 5%, respectively; P = .006) and a shorter time to failure (22.8 ± 13.2 vs 35.4 ± 15.4 months, respectively; P = .006) than older players.
  
  
  CONCLUSIONS
  Rugby players were likely to return to play after ACL reconstruction with a hamstring autograft. However, there was a higher risk of graft failure in younger players than in older players. On the basis of this study, we conclude that the hamstring autograft may not be an appropriate graft source to use in a younger active population, including rugby players.
  
  
  METHODS
  Level III, retrospective comparative study.
authors: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: ytakaza@juntendo.ac.jp.
authors: Yuji
authors: Y
authors: Takazawa
authors: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors: Hiroshi
authors: H
authors: Ikeda
authors: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors: Yoshitomo
authors: Y
authors: Saita
authors: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors: Takayuki
authors: T
authors: Kawasaki
authors: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors: Muneaki
authors: M
authors: Ishijima
authors: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors: Masataka
authors: M
authors: Nagayama
authors: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors: Haruka
authors: H
authors: Kaneko
authors: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors: Kazuo
authors: K
authors: Kaneko
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000070598:Anterior Cruciate Ligament Injuries / Q000503:physiopathology / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000706:statistics & numerical data*; D001265:Athletic Injuries / Q000503:physiopathology / Q000601:surgery*; D064592:Autografts; D005538:Football; D000070632:Hamstring Tendons / Q000637:transplantation*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D000068958:Return to Sport / Q000706:statistics & numerical data*; D017211:Treatment Failure; D055815:Young Adult