Family history, gender affect survival of ACL graft at 15-year follow-up

Family history, gender affect survival of ACL graft at 15-year follow-up

Bourke H. Am J Sports Med. 2012. doi:10.1177/0363546512454414.

• September 12, 2012

Patients who underwent primary ACL surgery 15 years ago report an 86% or higher survival rate for their graft at latest follow-up, according to this study.

Surgeons performed a single-incision endoscopic technique using either an autologous bone-patellar tendon-bone graft (BPTB) or hamstring tendon (HT) graft in 755 patients. At minimum 15 years follow-up, 689 patients completed a subjective questionnaire. The mean International Knee Documentation Committee subjective score was 85 at 15 years and 73% of patients reported return-to-sport preinjury levels, with 51% still performing strenuous or very strenuous activities, according to the abstract.

“Anterior cruciate ligament reconstruction using this technique is a reliable and reproducible procedure when using either the BPTB or HT autograft and allowed 73% of patients a return to their preinjury sports with an ACL graft rupture rate of less than 1% per year,” Henry E. Bourke, FRCS (Tr&Orth) stated in the study.

After the 2-, 5-, 10- and 15-year follow-up, expected survival of the ACL graft was 95%, 93%, 91% and 89%, respectively, according to the abstract. Expected survival of the contralateral ACL graft was 97%, 93%, 90% and 87% during the same respective follow-up periods. Although graft choice did not affect the risk of rupture, contralateral ACL grafts were twice as likely to rupture in the BPTB group as in the HT group.

Researchers also noted that risk factors for rupture included male gender, which lowered the chances of survival, and a family history of ACL rupture, which doubled the chances of rupture in both the ACL and contralateral ACL groups.