Primary Anterior Cruciate Ligament reconstruction performed with hamstring tendon autograft leads to an over four times greater rate of second ACL rupture after return to sport in patients with generalized joint hypermobility compared to bone-patellar tendon-bone autograft.
Jakob Lindskog, Johan Högberg, Rebecca Simonsson, Ramana Piussi, Bálint Zsidai, Kristian Samuelsson, Roland Thomeé, Eric Hamrin Senorski
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引用次数: 0
Abstract
Purpose: The purpose of this study was to examine the 12-month (12M), the 24-month (24M) and longest available time (LAT) rate of 1) second anterior cruciate ligament (ACL) rupture (graft rupture or contralateral ACL rupture), and 2) graft rupture alone, respectively, in patients with generalized joint hypermobility (GJH) following return to sport (RTS) after ACL reconstruction depending on graft choice, i.e., hamstring tendon (HT) autograft or bone-patellar tendon-bone (BPTB) autograft.
Methods: Data were extracted from a rehabilitation registry that comprised patients who had undergone ACL reconstruction between 2014-2022. Patients with GJH between 16-50 years of age who had ≥24 months follow-up time following RTS after ACL reconstruction with HT autograft (GJH-HT) or BPTB autograft (GJH-BPTB) were included. Cox proportional hazard regression model was used to examine the rate of 1) a second ACL rupture (graft rupture or contralateral ACL rupture), and 2) graft rupture alone, at 12M, 24M and at the LAT after RTS.
Results: Eighty-two patients (GJH-HT n=54 and GJH-BPTB n=28) of which 72.0% were females, with an average age of 22.7±7.4 years were included. The proportion of second ACL ruptures was greater in GJH-HT compared to GJH-BPTB at 12M (11/54, 20.4% versus 0/28, 0%, p=0.013), at 24M (13/54, 24.1% versus 1/28, 3.6%, p=0.028) and at LAT after RTS (16/54, 29.6% versus 2/28, 7.1%, p=0.024). The rate of second ACL rupture was greater in GJH-HT compared to GJH-BPTB (hazard ratio=4.98, p=0.032) at LAT after RTS. The proportion of patients with graft rupture was greater in GJH-HT compared to the GJH-BPTB at 12M (8/54, 14.8% versus 0/28, 0%, p=0.046), at 24M (10/54, 18.5% versus 0/28, 0%, p=0.013)and at LAT after RTS (12/54, 22.2% versus 0/28, 0%, p=0.006).
Conclusion: Over 4 times greater rate of second ACL rupture after RTS was reported for patients with GJH and who had ACL reconstruction performed with HT compared with BPTB autograft. Patients with GJH who were treated with BPTB autograft for ACL reconstruction did not experience graft rupture after RTS.
Level of evidence: Level III, Retrospective study.
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