A hamstring autograft diameter ≤ 8 mm is a safe option for smaller, lighter and female athletes who want to return to pivoting sports after ACL reconstruction

Abstract

Purpose To investigate the association between hamstring autograft diameter and ACL graft failure rate in athletes who successfully returned to pivoting sports after ACL reconstruction. Methods Retrospective evaluation of ACL graft failure rates in athletes who underwent ACL reconstruction with all-inside hamstring autograft and successfully returned to pivoting sports following postoperative rehabilitation. Athletes were divided into a ≤ 8 mm group and a > 8 mm group. Data about return to pivoting sports and ACL graft failures after ACL reconstruction were collected via a digital questionnaire. ACL graft failures were in all cases confirmed by an orthopaedic surgeon and/ or MRI. The association between hamstring autograft diameter and ACL graft failure rate was investigated using a Fisher's exact test in the subgroup of athletes who completed the digital questionnaire and returned to pivoting sports. Results Two-hundred and twenty-nine of the 422 athletes who completed the digital questionnaire (54.2%) returned to a pivoting sport and were included for final analyses. Ninety-seven (42.4%) of the athletes who returned to sport were in the ≤ 8 mm group (8 graft failures) and 132 (57.6%) in the > 8 mm group (10 graft failures). There were significantly more women (49.5 and 13.6% respectively; p < 0.001) and significantly smaller (1.75 and 1.81 m respectively; p < 0.001), lighter (72.2 and 79.6 kg respectively; p < 0.001) and younger (23.6 and 26.1 years old respectively; p = 0.015) athletes in the ≤ 8 mm group compared to the > 8 mm group. There was no significant association between hamstring autograft diameter and ACL graft failure rate. Conclusion A hamstring autograft diameter of ≤ 8 mm is a legitimate option for smaller, lighter and female athletes without increasing the risk for ACL graft failure. Level of evidence III.

Effectiveness of a rehabilitation protocol after anterior cruciate ligament reconstruction in returning to match rhythm: a case study of a professional soccer player

“…The impact of ACL injuries on athletes is substantial, with a high prevalence among both amateur and elite athletes (Piskin et al, 2021). Furthermore, ACL ruptures are relatively common knee injuries among athletes and can significantly impede an athlete's ability to engage in their desired activities (Boots, 2023). It is noteworthy that ACL injuries are not limited to professional athletes but also affect young student athletes, emphasizing the broad impact of these injuries across different levels of sports participation (Zink, 2024).…”