Risk of hamstring autograft failure higher after ACL surgery in young patients
BALTIMORE — ACL reconstruction with hamstring autografts demonstrate higher failure rates in patients aged 25 years or younger, but researchers found no statistically significant link between graft size or Tegner activity level and failure rate, according to study results presented here at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012.
“Patients 25 and younger have a higher failure rate with ACL reconstruction through hamstring autograft,” Przemyslaw M. Kamien, MD, said during his presentation.
“Hamstring tendons remain a very popular choice for autograft ACL reconstruction,” he said, noting that lately smaller hamstring autograft sites, however, have been associated with higher early revision rates.
Kamien said he and his colleagues looked at 98 patients who underwent ACL reconstruction with a hamstring autograft between 2000 and 2007. Those studied represented all age groups and activity levels and had at least 2 years follow-up.
“The failure rate in patients 25 and younger was pretty high: 25%,” Kamien said. “The failure rate in patients older than 25 was only 6%. This difference is statistically significant.”
There were 15 ACL reconstructions that qualified as failures, with 12 of them occurring in patients aged 25 years or younger. When Kamien and colleagues analyzed failure rate vs. age, they found a statistically significant relationship between the two factors. Graft size and failure rate, however, did not display statistical significance in either the complete patient population or the patients aged less than 25 years. Tegner activity level also was not related to failure rate in either population.
“We failed to find statistical significance between the Tegner activity score and graft site with failure, and although our failure rates were higher in patients with smaller grafts, the difference did not reach statistical significance in our group,” Kamien said.
Reference:
Barret GR, Kamien PM, Replogle WH, Hydrick J. Age, graft size, and Tegner activity level as predictors of failure in anterior cruciate ligament reconstruction with hamstring autograph. Paper #19. Presented at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012. July 12-15. Baltimore.
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