No difference in revision risk between autologous hamstring graft less than 8 mm versus hybrid graft 8 mm or larger in anterior cruciate ligament reconstruction.
Allograft
Anterior cruciate ligament reconstruction (ACLR)
Hamstring graft
Hybrid graft
Revision
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
28
11
2022
accepted:
24
04
2023
medline:
21
7
2023
pubmed:
4
5
2023
entrez:
4
5
2023
Statut:
ppublish
Résumé
Hamstring autograft (HA) is commonly used for primary anterior cruciate ligament reconstruction (ACLR). However, if the harvested HA is inadequate in diameter, it is often augmented with an allograft tendon, forming a hybrid graft (HY). This study sought to evaluate aseptic revision risk following HA versus HY ACLR. A retrospective cohort study was performed using data obtained from our healthcare system's ACLR registry. Patients ≤ 25 years of age who underwent primary isolated ACLR were identified (2005-2020). Graft type and diameter size was the primary exposure of interest: < 8 mm HA and ≥ 8 mm HY. A secondary analysis was performed to examine 7 mm HA and 7.5 mm HA vs ≥ 8 mm HY. Propensity score-weighted Cox proportional hazard regression was used to evaluate the risk of aseptic revision. The study sample included 1,945 ACLR: 548 ≥ 8 mm HY, 651 7 mm HA, and 672 7.5 mm HA. The crude cumulative aseptic revision probability at 8-years for ≥ 8 mm HY was 9.1%, 11.1% for 7 mm HA, and 11.2% for 7.5 mm HA. In adjusted analysis, no difference in revision risk was observed for < 8 mm HA (hazard ratio [HR] 1.15, 95% confidence interval [CI] 0.72-1.82), 7 mm HA (HR 1.23, 95% CI 0.71-2.11), or 7.5 mm HA (HR 1.16, 95% CI 0.74-1.82) compared to ≥ 8 mm HY. In a US-based cohort of ACLR patients aged ≤ 25 years, we failed to observe any differences in aseptic revision risk for HA < 8 mm compared to HY ≥ 8 mm. Augmentation of a HA as small as 7 mm is not necessary to prevent a revision surgery. Level III.
Identifiants
pubmed: 37140654
doi: 10.1007/s00167-023-07437-5
pii: 10.1007/s00167-023-07437-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3465-3473Informations de copyright
© 2023. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
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