SAN DIEGO — Female patients who received bone-patellar tendon-bone autograft had fewer graft retears compared with patients who received hamstring autograft after ACL reconstruction. In addition, greater rates of retears were seen in the youngest patients using hamstring autografts, according to data presented at the American Orthopaedic Society for Sports Medicine Annual Meeting.
“Patellar tendon may be a superior graft choice in females under the age of 20, particularly those with meniscal tears that are amendable to repair at the time of ACL reconstruction. Hamstrings tendon graft can be considered in patients over the age of 20, especially those concerned with the possibility of developing kneeling pain in the future,” Hytham Salem, BA, said here in his presentation here.
Salem and colleagues retrospectively reviewed data for 256 female patients between 15 and 25 years of age who underwent primary ACL reconstruction using either the bone-patellar tendon-bone (BTB) or hamstring autograft between January 2012 and May 2015. Overall, 175 patients had BTB autograft and 81 patients had quadrupled hamstring autografts. Patients with a prior history of ACL injury to either knee and patients with multi-ligament injury were excluded from the study. Patients were grouped by age – 15 to 20 years and 20 to 25 years. Researchers determined the occurrence of chondral, meniscal or ligamentous injury to the ipsilateral or contralateral knee in the first 2 years after ACL reconstruction.
Graft retear occurred in 6.9% of patients who had BTB and in 13.6% of patients who had hamstring autograft. Contralateral ACL tear occurred in 7.4% of BTB patients and in 6.2% of hamstring patients. By age, patients in the 15- to 20-year-old group had a lower rate of retear with 6.4% in the BTB group compared with 17.5% in the hamstring group. However, of the 11 failures in the hamstring group, four patients had allograft augmentation, and when eliminated, the difference was rendered statistically insignificant. This same difference was not observed in female patients in the 20- to 25-year-old age group. – by Kristine Houck, MA, ELS
Greater rates of retears were seen in the youngest patients using hamstring autografts.
Kristine Houck, MA, ELS
Salem H, et al. Abstract 104. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 5-8, 2018; San Diego.
Disclosure: Salem reports no relevant financial disclosures.