Graft failure is more frequent after hamstring than patellar tendon autograft

Laboute, E.; James-Belin, E.; Puig, Pere; Trouvé, P.; Verhaeghe, E.

doi:10.1007/s00167-018-4982-7

Cited by 43 publications

(43 citation statements)

References 37 publications

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“…Just like physical activity and graft choice, age at the time of surgery has been shown to be a risk factor for ACL revision surgery in patients with HT or BPTB autografts, with younger patients being at a higher risk for future graft ruptures. 8,16,19,32,45 In the present study, these findings were confirmed for patients treated with QT or HT autografts, with a higher risk of revision surgery, up to 5.5 times, in children and adolescents younger than 15 years as compared with older age groups (Table 5).…”

Section: Discussionsupporting

confidence: 83%

“…These rates are in the upper range of the reported rupture rates for HT and QT autografts. 19,47 This may be related to the number of highly active patients in our cohort, with a mean Tegner activity score of 5.9 (median, 6) and with over one-third of patients (36.2%) having a score .6. High physical activity is a well-known risk factor for ACL rupture and rerupture.…”

Section: Discussionmentioning

confidence: 95%

“…High physical activity is a well-known risk factor for ACL rupture and rerupture. 1,19,31,33 Borchers et al 1 found 5.53-times greater odds of graft failure in a highly active cohort as compared with less active patients. Similar results were reported by Salmon et al, 38 who reported a 2.5-times greater risk of graft failure in patients returning to level 1 or 2 sports.…”

Section: Discussionmentioning

confidence: 98%

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Anterior Cruciate Ligament Reconstructions With Quadriceps Tendon Autograft Result in Lower Graft Rupture Rates but Similar Patient-Reported Outcomes as Compared With Hamstring Tendon Autograft: A Comparison of 875 Patients

et al. 2020

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Background: Graft rupture is a devastating outcome after anterior cruciate ligament (ACL) reconstruction (ACLR). Little is known about graft rupture rates as well as clinical and functional outcomes after ACLR with quadriceps tendon (QT) autografts. Purpose: To compare QT with hamstring tendon (HT) autografts in terms of the rates of graft and contralateral ACL rupture as well as patient-reported outcome measures. Study Design: Cohort study; Level of evidence, 3. Methods: All primary ACLRs performed between 2010 and 2016 were followed prospectively for 24 months through the recording of graft ruptures and contralateral ACL injuries as well as patient-administered questionnaires. Results: A total of 875 patients were included in the study. Three factors—graft type, age group, and activity level—had a significant value in predicting the need for revision surgery. The odds of revision surgery were 5.5 times greater in children younger than 15 years than in adults older than 45 years, 3.6 times greater in patients with high activity levels than low activity levels, and 2.7 times greater in patients receiving an HT autograft as compared with a QT autograft. A significantly higher rate of ipsilateral graft ruptures versus contralateral ACL injuries was observed in the HT group (4.9% vs 2.3%; odds ratio, 2.1; P = .01) but not in the QT group (2.8% vs 2.3%). The difference in the ratios of graft and contralateral ACL ruptures was even more pronounced in highly active patients treated with HT autografts (11.1% vs 4.2%; odds ratio, 2.6; P = .01) as compared with QT autografts (5.0% vs 2.8%; P = .48). Two-year measures of Lysholm scores (mean ± SD: QT, 86.0 ± 22.3; HT, 89.4 ± 16.4) and Tegner activity scores (QT, 6.1 ± 2.0; HT, 5.7 ± 1.9) as well as visual analog scale pain (QT, 0.8 ± 1.3; HT, 0.7 ± 1.1) did not differ between grafts. Conclusion: Graft choice does not influence clinical and functional outcomes 2 years after ACLR. However, 3 factors—graft type, age group, and activity level—have a significant value in predicting the need for revision surgery. Patients treated with HT autografts have a significantly higher, activity-dependent risk of revision surgery and experience more ipsilateral graft ruptures than subsequent contralateral ACL injuries when compared with patients treated with QT autografts. Young age and high activity level are significant predictors for ACL revision surgery.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Anterior Cruciate Ligament Reconstructions With Quadriceps Tendon Autograft Result in Lower Graft Rupture Rates but Similar Patient-Reported Outcomes as Compared With Hamstring Tendon Autograft: A Comparison of 875 Patients

et al. 2020

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“…After an average time of 10.5 years from surgery, mean postoperative KOOS score was 88.5 (SD 8.5), while mean IKDC subjective score was 87.5 (SD 10.9). Rupture rate was 6.4% (14 on 204 patients), as previously reported in literature for hamstring ACL reconstruction 18 .…”

Section: Discussionsupporting

confidence: 82%

Return to sports and re-rupture rate following anterior cruciate ligament reconstruction in amateur sportsman: long-term outcomes

Legnani

Peretti

et al. 2019

J Sports Med Phys Fitness

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BACKGROUNDː The aim of this study was to retrospectively evaluate patient satisfaction, the return-to-sport rate and activity level at a long-term follow-up in a large cohort of amateur sportsmen who underwent primary ACL reconstruction. METHODSː a total of 218 patients who underwent primary ACL reconstruction between 2004 and 2011, were successfully recontacted and retrospectively reviewed at an average follow-up of 10.5 years (range, 7 to 14 years). All surgeries were performed by one single surgeon. All of them underwent primary ACL reconstruction with autogenous hamstring tendon grafts. Assessment included Knee Osteoarthritis Outcome Score (KOOS) score, International Knee Documentation Committee (IKDC) Subjective Knee Form, Tegner activity level. Patients were also asked what kind of injury they sustained (either direct or indirect trauma), what kind of sport they were performing when they got injured, at what time they did return to sports and which sport they practised before and after surgery. RESULTSː Fourteen patients underwent re-rupture. In 11 cases, this was due to a new trauma occurring at an average time of 22.9 (SD 23.8) months following primary surgery. In 3 cases rupture occurred during rehabilitation period. Mean postoperative KOOS score was 88.5 (SD 8.5), while mean IKDC subjective score was 87.5 (SD 10.9). At the time of followup, most patients (214 subjects, 98%) were participating in sport. 156 subjects returned to pre-injury level (71.6%). CONCLUSIONSː The study reported long-term favourable subjective outcomes in amateur sportsman following ACL reconstruction, with a low re-rupture rate and a high percentage of subjects (93.6%) returning to sports participation 12 months after surgery. Most patients (71.6%) were able to return to their preprimary level of activity and sport. Younger age at the time of ACL reconstruction positively affected return to sports; however, younger patients were significantly more likely than older patients to undergo re-rupture.

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“…If we consider high-risk graft rupture patients, several studies show that the BPTB graft has a lower failure rate than HT graft. Laboute et al 22 followed 955 athletes who underwent ACLR with HT or BPTB grafts. The results demonstrated a significant difference in the rate of graft failure (6.5% for HT graft vs 2.1% for BPTB grafts) with an adjusted OR of 3.64, 95% CI (1.55 to 10.67); p=0.007.…”

Section: High-risk Patientsmentioning

confidence: 99%

Current evidence around patellar tendon graft in ACLR for high-risk patients: current concepts

2020

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Graft failure is more frequent after hamstring than patellar tendon autograft

Abstract: II.

Cited by 43 publications

References 37 publications

Anterior Cruciate Ligament Reconstructions With Quadriceps Tendon Autograft Result in Lower Graft Rupture Rates but Similar Patient-Reported Outcomes as Compared With Hamstring Tendon Autograft: A Comparison of 875 Patients

Anterior Cruciate Ligament Reconstructions With Quadriceps Tendon Autograft Result in Lower Graft Rupture Rates but Similar Patient-Reported Outcomes as Compared With Hamstring Tendon Autograft: A Comparison of 875 Patients

Return to sports and re-rupture rate following anterior cruciate ligament reconstruction in amateur sportsman: long-term outcomes

Current evidence around patellar tendon graft in ACLR for high-risk patients: current concepts

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