Long-term rate of graft failure after ACL reconstruction: a geographic population cohort analysis

Thomas L. Sanders, Ayoosh Pareek, Timothy Hewett, Bruce A Levy, Diane L. Dahm, Michael J. Stuart, Aaron Krych

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: Graft failure following anterior cruciate ligament reconstruction (ACLR) is a devastating injury among patients returning to activity. The goals of this study were to define the long-term rate of graft failure after ACLR in the general population and evaluate factors associated with graft failure. Methods: This long-term observational study included a population-based incidence cohort of patients who underwent primary ACLR after diagnosis with new-onset, isolated ACL tears between 1990 and 2010. For all patients, a chart review was performed to collect information related to the initial injury, treatment, and outcomes. Patients were retrospectively followed to determine the incidence of graft failure following ACLR. Results: The study cohort consisted of 1355 patients with new-onset, isolated ACL tears treated with ACLR. At a mean follow-up of 10.0 years (±6.4 years) following ACLR, a total of 72 patients (5.3 %) sustained ipsilateral graft failure. The graft survival following ACLR was 99.7 % at 1 year, 96 % at 5 years, 94 % at 10 years, 93 % at 15 years, 92 % at 20 years and 91 % at 25 years. Among patients 22 years or younger (n = 571), the rate of graft failure was significantly higher compared to patients older than 22 years (6.3 vs. 4.6 %, p = 0.04). The rate of graft failure decreased significantly over the 21-year observation period of this study (p < 0.0001). Conclusions: Among all patients receiving primary ACLR, graft failure remains an uncommon but functionally devastating outcome with an estimated graft survival rate of 91 % at 25 years following surgery. Patients aged 22 or younger had a significantly higher rate of graft failure than older patients. The rate of graft failure decreased over the 21-year span of this study. Level of evidence: Retrospective case series, Level IV.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalKnee Surgery, Sports Traumatology, Arthroscopy
DOIs
StateAccepted/In press - Aug 13 2016

Fingerprint

Anterior Cruciate Ligament Reconstruction
Cohort Studies
Transplants
Population
Graft Survival
Incidence
Wounds and Injuries
Observational Studies
Survival Rate
Observation

Keywords

  • ACL
  • Anterior cruciate ligament
  • Graft disruption
  • Retear

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Orthopedics and Sports Medicine

Cite this

Long-term rate of graft failure after ACL reconstruction : a geographic population cohort analysis. / Sanders, Thomas L.; Pareek, Ayoosh; Hewett, Timothy; Levy, Bruce A; Dahm, Diane L.; Stuart, Michael J.; Krych, Aaron.

In: Knee Surgery, Sports Traumatology, Arthroscopy, 13.08.2016, p. 1-7.

Research output: Contribution to journalArticle

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abstract = "Purpose: Graft failure following anterior cruciate ligament reconstruction (ACLR) is a devastating injury among patients returning to activity. The goals of this study were to define the long-term rate of graft failure after ACLR in the general population and evaluate factors associated with graft failure. Methods: This long-term observational study included a population-based incidence cohort of patients who underwent primary ACLR after diagnosis with new-onset, isolated ACL tears between 1990 and 2010. For all patients, a chart review was performed to collect information related to the initial injury, treatment, and outcomes. Patients were retrospectively followed to determine the incidence of graft failure following ACLR. Results: The study cohort consisted of 1355 patients with new-onset, isolated ACL tears treated with ACLR. At a mean follow-up of 10.0 years (±6.4 years) following ACLR, a total of 72 patients (5.3 {\%}) sustained ipsilateral graft failure. The graft survival following ACLR was 99.7 {\%} at 1 year, 96 {\%} at 5 years, 94 {\%} at 10 years, 93 {\%} at 15 years, 92 {\%} at 20 years and 91 {\%} at 25 years. Among patients 22 years or younger (n = 571), the rate of graft failure was significantly higher compared to patients older than 22 years (6.3 vs. 4.6 {\%}, p = 0.04). The rate of graft failure decreased significantly over the 21-year observation period of this study (p < 0.0001). Conclusions: Among all patients receiving primary ACLR, graft failure remains an uncommon but functionally devastating outcome with an estimated graft survival rate of 91 {\%} at 25 years following surgery. Patients aged 22 or younger had a significantly higher rate of graft failure than older patients. The rate of graft failure decreased over the 21-year span of this study. Level of evidence: Retrospective case series, Level IV.",
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T2 - a geographic population cohort analysis

AU - Sanders, Thomas L.

AU - Pareek, Ayoosh

AU - Hewett, Timothy

AU - Levy, Bruce A

AU - Dahm, Diane L.

AU - Stuart, Michael J.

AU - Krych, Aaron

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N2 - Purpose: Graft failure following anterior cruciate ligament reconstruction (ACLR) is a devastating injury among patients returning to activity. The goals of this study were to define the long-term rate of graft failure after ACLR in the general population and evaluate factors associated with graft failure. Methods: This long-term observational study included a population-based incidence cohort of patients who underwent primary ACLR after diagnosis with new-onset, isolated ACL tears between 1990 and 2010. For all patients, a chart review was performed to collect information related to the initial injury, treatment, and outcomes. Patients were retrospectively followed to determine the incidence of graft failure following ACLR. Results: The study cohort consisted of 1355 patients with new-onset, isolated ACL tears treated with ACLR. At a mean follow-up of 10.0 years (±6.4 years) following ACLR, a total of 72 patients (5.3 %) sustained ipsilateral graft failure. The graft survival following ACLR was 99.7 % at 1 year, 96 % at 5 years, 94 % at 10 years, 93 % at 15 years, 92 % at 20 years and 91 % at 25 years. Among patients 22 years or younger (n = 571), the rate of graft failure was significantly higher compared to patients older than 22 years (6.3 vs. 4.6 %, p = 0.04). The rate of graft failure decreased significantly over the 21-year observation period of this study (p < 0.0001). Conclusions: Among all patients receiving primary ACLR, graft failure remains an uncommon but functionally devastating outcome with an estimated graft survival rate of 91 % at 25 years following surgery. Patients aged 22 or younger had a significantly higher rate of graft failure than older patients. The rate of graft failure decreased over the 21-year span of this study. Level of evidence: Retrospective case series, Level IV.

AB - Purpose: Graft failure following anterior cruciate ligament reconstruction (ACLR) is a devastating injury among patients returning to activity. The goals of this study were to define the long-term rate of graft failure after ACLR in the general population and evaluate factors associated with graft failure. Methods: This long-term observational study included a population-based incidence cohort of patients who underwent primary ACLR after diagnosis with new-onset, isolated ACL tears between 1990 and 2010. For all patients, a chart review was performed to collect information related to the initial injury, treatment, and outcomes. Patients were retrospectively followed to determine the incidence of graft failure following ACLR. Results: The study cohort consisted of 1355 patients with new-onset, isolated ACL tears treated with ACLR. At a mean follow-up of 10.0 years (±6.4 years) following ACLR, a total of 72 patients (5.3 %) sustained ipsilateral graft failure. The graft survival following ACLR was 99.7 % at 1 year, 96 % at 5 years, 94 % at 10 years, 93 % at 15 years, 92 % at 20 years and 91 % at 25 years. Among patients 22 years or younger (n = 571), the rate of graft failure was significantly higher compared to patients older than 22 years (6.3 vs. 4.6 %, p = 0.04). The rate of graft failure decreased significantly over the 21-year observation period of this study (p < 0.0001). Conclusions: Among all patients receiving primary ACLR, graft failure remains an uncommon but functionally devastating outcome with an estimated graft survival rate of 91 % at 25 years following surgery. Patients aged 22 or younger had a significantly higher rate of graft failure than older patients. The rate of graft failure decreased over the 21-year span of this study. Level of evidence: Retrospective case series, Level IV.

KW - ACL

KW - Anterior cruciate ligament

KW - Graft disruption

KW - Retear

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