Augmentation of small hamstring autografts did not reduce failure rates in ACL reconstruction
Augmentation of small hamstring tendon autografts in adolescent patients who underwent ACL reconstruction did not reduce graft failure rates and may yield higher retear rates with earlier graft failure, according to results.
Andrew T. Pennock , MD, and colleagues grouped 50 adolescents (38% were male patients) who had a quadrupled graft size of less than 7 mm and were undergoing primary ACL reconstruction based on the surgeon’s preference either to augment the grafts with allograft (n=26) or to accept the smaller autograft (n=24). Researchers documented preoperative demographics, injury and intraoperative data, and contacted all patients to obtain information about outcomes, subsequent procedures and complications.
At 2-year follow-up, 40 patients were available. With the exception of the extremity side, researchers found no between-group differences with respect to any of the preoperative or intraoperative variables. The augmented group had mean graft size of 8.9 mm, while the nonaugmented group had a mean graft size of 6.4 mm. Researchers noted graft failure in 30% of patients in the augmented group vs. 5% of patients in the nonaugmented group at a mean follow-up of 3 years. Results showed almost all of the graft failures in the augmented group occurred within 1 year of surgery, while the single failure in the nonaugmented group occurred 2.7 years postoperatively. Patients in the augmented and nonaugmented groups who did not experience graft failure showed no differences in the reported outcomes. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.