Risk factors for graft rerupture after revision anterior cruciate ligament reconstruction
Refereed conference paper presented and published in conference proceedings
CUHK Authors
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AbstractBackground: The literature on revision anterior cruciate ligament reconstruction (ACLR) is sparse. While it is well known that revision surgery is associated with significantly higher graft rerupture rates, the risk factors for repeated failure are not well defined. This study aims to explore the outcomes and risk factors of revision ACLR.
Methods: Revision ACLR performed between January 2013 and January 2023 were included. Univariable logistic regression models explored the association between graft re-rupture and prognostic variables. Those achieving statistical significance were included in a multivariable logistic regression model to identify risk factors of graft re-rupture.
Results: 132 revision ACLRs were identified (91 males; 41 females) with a mean age of 23.1 years (range 15-48). Pivoting sports accounted for 87.9% (n=116) of preinjury sports, with the majority being football (n=48; 36.4%). The mean graft
diameter was 9.26 mm (range 7.0-10.5 mm). MRI detected concomitant pathologies on the medial meniscus (n=45; 34.1%), lateral meniscus (n=41; 31.1%), and chondral pathologies (n=26; 19.7%). The graft rerupture rate was 16.7% (n=22) and 11.4% (n=15) of the revision ALCRs were revised a second time. A cut-off value of 9 mm was the optimum graft diameter during revision ACLR (AUC=0.63; p=0.049). Risk factors for re-rupture were graft diameter <9 mm (OR=3.873; p=0.031) and return to pivoting sport (OR=4.105; p=0.049).
Conclusion: Small graft diameter <9 mm and return to pivoting sport are risk factors for re-rupture. Techniques to maximise graft diameter and lateral reinforcement procedures to constrain pivoting motion may help reduce the incidence of graft rerupture following revision ACLR.
Methods: Revision ACLR performed between January 2013 and January 2023 were included. Univariable logistic regression models explored the association between graft re-rupture and prognostic variables. Those achieving statistical significance were included in a multivariable logistic regression model to identify risk factors of graft re-rupture.
Results: 132 revision ACLRs were identified (91 males; 41 females) with a mean age of 23.1 years (range 15-48). Pivoting sports accounted for 87.9% (n=116) of preinjury sports, with the majority being football (n=48; 36.4%). The mean graft
diameter was 9.26 mm (range 7.0-10.5 mm). MRI detected concomitant pathologies on the medial meniscus (n=45; 34.1%), lateral meniscus (n=41; 31.1%), and chondral pathologies (n=26; 19.7%). The graft rerupture rate was 16.7% (n=22) and 11.4% (n=15) of the revision ALCRs were revised a second time. A cut-off value of 9 mm was the optimum graft diameter during revision ACLR (AUC=0.63; p=0.049). Risk factors for re-rupture were graft diameter <9 mm (OR=3.873; p=0.031) and return to pivoting sport (OR=4.105; p=0.049).
Conclusion: Small graft diameter <9 mm and return to pivoting sport are risk factors for re-rupture. Techniques to maximise graft diameter and lateral reinforcement procedures to constrain pivoting motion may help reduce the incidence of graft rerupture following revision ACLR.
All Author(s) ListJonathan Patrick Ng, Victor Yan Zhe Lu, Dennis Hei Yin Lee, Simon Ho Yin Tsui, James Hong Yin Woo, Thomas Chun Hei Lo, Jack Wai Wang Chau, Michael Tim Yun Ong, Patrick Shu Hang Yung
Name of ConferenceThe HKOA 43rd Annual Congress of The Hong Kong Orthopaedic Association
Start Date of Conference04/11/2023
End Date of Conference05/11/2023
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
Year2023
Month11
PublisherHong Kong Academy of Medicine Press
Place of PublicationHong Kong
Pages27 - 27
LanguagesEnglish-United States
