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- Title
Long-term rate of graft failure after ACL reconstruction: a geographic population cohort analysis.
- Authors
Sanders, Thomas; Pareek, Ayoosh; Hewett, Timothy; Levy, Bruce; Dahm, Diane; Stuart, Michael; Krych, Aaron; Sanders, Thomas L; Hewett, Timothy E; Levy, Bruce A; Dahm, Diane L; Stuart, Michael J; Krych, Aaron J
- Abstract
<bold>Purpose: </bold>Graft failure following anterior cruciate ligament reconstruction (ACLR) is a devastating injury among patients returning to activity. The goals of this study were to define the long-term rate of graft failure after ACLR in the general population and evaluate factors associated with graft failure.<bold>Methods: </bold>This long-term observational study included a population-based incidence cohort of patients who underwent primary ACLR after diagnosis with new-onset, isolated ACL tears between 1990 and 2010. For all patients, a chart review was performed to collect information related to the initial injury, treatment, and outcomes. Patients were retrospectively followed to determine the incidence of graft failure following ACLR.<bold>Results: </bold>The study cohort consisted of 1355 patients with new-onset, isolated ACL tears treated with ACLR. At a mean follow-up of 10.0 years (±6.4 years) following ACLR, a total of 72 patients (5.3 %) sustained ipsilateral graft failure. The graft survival following ACLR was 99.7 % at 1 year, 96 % at 5 years, 94 % at 10 years, 93 % at 15 years, 92 % at 20 years and 91 % at 25 years. Among patients 22 years or younger (n = 571), the rate of graft failure was significantly higher compared to patients older than 22 years (6.3 vs. 4.6 %, p = 0.04). The rate of graft failure decreased significantly over the 21-year observation period of this study (p < 0.0001).<bold>Conclusions: </bold>Among all patients receiving primary ACLR, graft failure remains an uncommon but functionally devastating outcome with an estimated graft survival rate of 91 % at 25 years following surgery. Patients aged 22 or younger had a significantly higher rate of graft failure than older patients. The rate of graft failure decreased over the 21-year span of this study.<bold>Level Of Evidence: </bold>Retrospective case series, Level IV.
- Subjects
ANTERIOR cruciate ligament surgery; ANTERIOR cruciate ligament injuries; HOMOGRAFTS; REOPERATION; GERIATRIC surgery; TENDON transplantation; PATELLAR ligament transplantation; AUTOGRAFTS; BONE grafting; GRAFT versus host reaction; KNEE injuries; LONGITUDINAL method; SURGICAL complications; DISEASE relapse; DISEASE incidence; RETROSPECTIVE studies
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2017, Vol 25, Issue 1, p222
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-016-4275-y