2015 ISAKOS Biennial Congress ePoster #1251

Influence of Sex, Activity, and Graft Type on the Time to Failure in ACL Reconstruction Retears

Christopher C. Kaeding, MD, Columbus, OH UNITED STATES
Matthew Schroeder, PhD, Columbus, OH UNITED STATES
Angela Pedroza, MPH, Columbus, OH UNITED STATES
The Ohio State University, Columbus, Ohio, USA

FDA Status Not Applicable

Summary: In ACL reconstructions with graft retear, the median time to retear was 24 months with activity having the most impact on the time to failure (17 vs 51 months) and female gender also influencing retear time, whereas graft choice (autograft/allograft) did not impact time to failure.

Abstract:

Introduction

This study of ACL reconstruction (ACLR) graft retears has two aims: 1) report time to retear in ACLR grafts that retear and 2) describe the influence of sex, activity level, and graft type have on the time to failure.

Methods

Time to failure (TTF) was defined as the time interval from primary ACLR to graft retear. Demographic, questionnaire, surgical, and date of injury data were collected from subjects who sustained a secondary ACL tear from 3 academic institutions. Sex, Marx activity level, and graft type (autograft/allograft) were analyzed for their impact on the TTF. Activity was stratified to high activity (Marx 12+) or low activity (Marx<12).

Results

136 subjects were in the cohort with 54.4% males. Median time to failure was 24 months. The TTF was less than 1 year in 35% of patients, between 1 and 2 years for 16%, and greater than 2 years in 49% of patients. Nearly 12% experienced a TTF of 10 years or more. The median age at primary ACLR was similar for males and females (19 and 17.5 years, respectively; p=0.187). Median age at revision ACLR was also similar, 24 years for males (95% CI: 14-48) and 22 years for females (95% CI: 10-58). The median TTF for females was less than males (16 and 30 months, respectively; p= 0.041). High activity classification was similar between males (60.8%) and females (51.6%). The median TTF for the high activity group, 17 months, was shorter than the low activity group, 51 months (p=0.001). When stratified on activity level, the median TTF of high activity females (11 months) was less than the high activity males (24 months) (p=0.004). However in the low activity group there was no difference in TFF between the sexes (p=0.481). Primary ACLR graft type was autograft 72% and allograft 28%. The median TTF for allografts and autografts was not different (p=0.499). When stratified on graft type, no difference in TFF between sexes was observed in the autograft group (p=0.623). However, in the allograft group, females had a significantly shorter median TTF of 12 months versus the males’ 51 months (p= 0.004).

Conclusion

In the entire cohort, the median TTF was 24 months. Allografts and autografts had similar TTF. Median TTF for high activity patients was significantly less, 17 months versus 51 months, than for low activity patients. Low activity males and females had similar TTF, but high activity females had significantly shorter TTF than high activity males (11 vs 24 months). Activity level was most impactful on TTF, with female gender also influencing retear time. Graft choice did not impact TTF.