The Effect of a Hamstring Tendon Autograft With a Diameter ≥8 mm on Graft Failure or Contralateral ACL Ruptures at 2 Years After ACL Reconstruction.

IF 2.5 3区医学 Q2 ORTHOPEDICS

Orthopaedic Journal of Sports Medicine Pub Date : 2025-08-12 eCollection Date: 2025-08-01 DOI:10.1177/23259671251321831

Connor W Hoban, Chao Zhang, Yuxuan Jin, Paul M Saluan, Lutul D Farrow, James T Rosneck, Morgan H Jones, Anthony Miniaci, Brian M Leo, Richard D Parker, Michael W Kattan, Kurt P Spindler

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引用次数: 0

Abstract

Background: A decreased hamstring tendon (HT) autograft diameter has been associated with higher rates of failure in primary anterior cruciate ligament reconstruction (ACLR).

Purpose: To determine whether an HT autograft diameter ≥8 mm has an effect on the risk of graft failure and subsequent knee surgery after ACLR in a prospective cohort.

Study design: Cohort study; Level of evidence, 2.

Methods: Patients undergoing primary ACLR with an HT autograft were included and followed prospectively for 2 years to capture subsequent surgery events performed in either knee. The effect of HT autograft diameter on the risk of subsequent surgery was analyzed using multivariable regression modeling that adjusted for patient age, sex, body mass index, and Marx activity score.

Results: Of 421 eligible patients, 381 (90.5%) had a minimum 2-year follow-up and were included in analysis. The median autograft diameter was 8.5 mm (interquartile range, 8.0-9.0 mm); 90.8% of patients received an autograft with a diameter ≥8 mm. There were 59 patients (15.5%) who underwent subsequent ipsilateral knee surgery, including 27 patients (7.1%) who had graft failure and underwent revision ACLR within 2 years. HT autograft diameter was not associated with the risk of all subsequent ipsilateral knee surgery (odds ratio [OR], 0.87 [95% CI, 0.56-1.36]; P = .536) or revision ACLR (OR, 0.71 [95% CI, 0.38-1.33]; P = .286). A Marx activity score ≥12 was associated with an increased risk of all subsequent ipsilateral knee surgery (OR, 2.55 [95% CI, 1.41-4.59]; P = .002). Younger age was associated with an increased risk of revision ACLR (OR, 0.16 [95% CI, 0.05-0.51]; P = .002).

Conclusion: A minimum HT autograft diameter of 8 mm was not associated with the risk of revision ACLR or other subsequent surgery in the ipsilateral or contralateral knee. This study may guide intraoperative decision making regarding HT autograft implementation in ACLR.

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直径≥8mm的腘绳肌腱自体移植物对ACL重建2年后移植物失败或对侧ACL断裂的影响

背景：腘绳肌腱（HT）自体移植物直径减小与原发性前交叉韧带重建（ACLR）失败率升高相关。目的：在一项前瞻性队列研究中，确定直径≥8mm的HT自体移植物是否对ACLR术后移植物失败和随后的膝关节手术风险有影响。研究设计：队列研究；证据等级2。方法：纳入接受原发性ACLR合并HT自体移植物的患者，前瞻性随访2年，以记录后续双膝手术事件。采用多变量回归模型分析HT自体移植物直径对后续手术风险的影响，该模型调整了患者的年龄、性别、体重指数和马克思活动评分。结果：在421例符合条件的患者中，381例（90.5%）进行了至少2年的随访，并被纳入分析。自体移植物中位直径为8.5 mm（四分位数间距为8.0-9.0 mm）；90.8%的患者接受直径≥8mm的自体移植物。59例患者（15.5%）接受了随后的同侧膝关节手术，其中27例患者（7.1%）因移植物失败而在2年内接受了改良ACLR。HT自体移植物直径与随后所有同侧膝关节手术的风险无关(优势比[OR]， 0.87 [95% CI, 0.56-1.36]；P = .536)或修正ACLR (or, 0.71 [95% CI, 0.38-1.33]；P = .286)。Marx活动评分≥12与所有后续同侧膝关节手术的风险增加相关(OR, 2.55 [95% CI, 1.41-4.59]；P = .002)。年龄越小，ACLR修正的风险越高(OR, 0.16 [95% CI, 0.05-0.51]；P = .002)。结论：最小直径为8mm的HT自体移植物与同侧或对侧膝关节翻修ACLR或其他后续手术的风险无关。本研究可指导ACLR患者HT自体移植物的术中决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

7.70%

发文量

876

审稿时长

12 weeks

期刊介绍： The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).