PURPOSE: The purpose of this study was to evaluate the effect of graft size on patient-reported outcomes and revision risk after anterior cruciate ligament (ACL) reconstruction. METHODS: A retrospective chart review of prospectively collected cohort data was performed, and 263 of 320 consecutive patients (82.2%) undergoing primary ACL reconstruction with hamstring autograft were evaluated. We recorded graft size; femoral tunnel drilling technique; patient age, sex, and body mass index at the time of ACL reconstruction; Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee score preoperatively and at 2 years postoperatively; and whether each patient underwent revision ACL reconstruction during the 2-year follow-up period. Revision was used as a marker for graft failure. The relation between graft size and patient-reported outcomes was determined by multiple linear regression. The relation between graft size and risk of revision was determined by dichotomizing graft size at 8 mm and stratifying by age. RESULTS: After we controlled for age, sex, operative side, surgeon, body mass index, graft choice, and femoral tunnel drilling technique, a 1-mm increase in graft size was noted to correlate with a 3.3-point increase in the KOOS pain subscale (P = .003), a 2.0-point increase in the KOOS activities of daily living subscale (P = .034), a 5.2-point increase in the KOOS sport/recreation function subscale (P = .004), and a 3.4-point increase in the subjective International Knee Documentation Committee score (P = .026). Revision was required in 0 of 64 patients (0.0%) with grafts greater than 8 mm in diameter and 14 of 199 patients (7.0%) with grafts 8 mm in diameter or smaller (P = .037). Among patients aged 18 years or younger, revision was required in 0 of 14 patients (0.0%) with grafts greater than 8 mm in diameter and 13 of 71 patients (18.3%) with grafts 8 mm in diameter or smaller. CONCLUSIONS: Smaller hamstring autograft size is a predictor of poorer KOOS sport/recreation function 2 years after primary ACL reconstruction. A larger sample size is required to confirm the relation between graft size and risk of revision ACL reconstruction. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
PURPOSE: The purpose of this study was to evaluate the effect of graft size on patient-reported outcomes and revision risk after anterior cruciate ligament (ACL) reconstruction. METHODS: A retrospective chart review of prospectively collected cohort data was performed, and 263 of 320 consecutive patients (82.2%) undergoing primary ACL reconstruction with hamstring autograft were evaluated. We recorded graft size; femoral tunnel drilling technique; patient age, sex, and body mass index at the time of ACL reconstruction; Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee score preoperatively and at 2 years postoperatively; and whether each patient underwent revision ACL reconstruction during the 2-year follow-up period. Revision was used as a marker for graft failure. The relation between graft size and patient-reported outcomes was determined by multiple linear regression. The relation between graft size and risk of revision was determined by dichotomizing graft size at 8 mm and stratifying by age. RESULTS: After we controlled for age, sex, operative side, surgeon, body mass index, graft choice, and femoral tunnel drilling technique, a 1-mm increase in graft size was noted to correlate with a 3.3-point increase in the KOOS pain subscale (P = .003), a 2.0-point increase in the KOOS activities of daily living subscale (P = .034), a 5.2-point increase in the KOOS sport/recreation function subscale (P = .004), and a 3.4-point increase in the subjective International Knee Documentation Committee score (P = .026). Revision was required in 0 of 64 patients (0.0%) with grafts greater than 8 mm in diameter and 14 of 199 patients (7.0%) with grafts 8 mm in diameter or smaller (P = .037). Among patients aged 18 years or younger, revision was required in 0 of 14 patients (0.0%) with grafts greater than 8 mm in diameter and 13 of 71 patients (18.3%) with grafts 8 mm in diameter or smaller. CONCLUSIONS: Smaller hamstring autograft size is a predictor of poorer KOOS sport/recreation function 2 years after primary ACL reconstruction. A larger sample size is required to confirm the relation between graft size and risk of revision ACL reconstruction. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Authors: Rick W Wright; Warren R Dunn; Annunziato Amendola; Jack T Andrish; John Bergfeld; Christopher C Kaeding; Robert G Marx; Eric C McCarty; Richard D Parker; Michelle Wolcott; Brian R Wolf; Kurt P Spindler Journal: Am J Sports Med Date: 2007-04-23 Impact factor: 6.202
Authors: James J Irrgang; Allen F Anderson; Arthur L Boland; Christopher D Harner; Philippe Neyret; John C Richmond; K Donald Shelbourne Journal: Am J Sports Med Date: 2006-07-26 Impact factor: 6.202
Authors: Emily K Reinke; Kurt P Spindler; Dawn Lorring; Morgan H Jones; Leah Schmitz; David C Flanigan; Angel Qi An; Amanda R Quiram; Emily Preston; Michael Martin; Bettina Schroeder; Richard D Parker; Christopher C Kaeding; Lynn Borzi; Angela Pedroza; Laura J Huston; Frank E Harrell; Warren R Dunn Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-03-29 Impact factor: 4.342
Authors: Mattias Ahldén; Kristian Samuelsson; Ninni Sernert; Magnus Forssblad; Jón Karlsson; Jüri Kartus Journal: Am J Sports Med Date: 2012-09-07 Impact factor: 6.202
Authors: Jeffrey M Tuman; David R Diduch; L Joseph Rubino; Joshua A Baumfeld; Henry S Nguyen; Joseph M Hart Journal: Am J Sports Med Date: 2007-07-20 Impact factor: 6.202
Authors: Christopher C Kaeding; Brian Aros; Angela Pedroza; Eric Pifel; Annunziato Amendola; Jack T Andrish; Warren R Dunn; Robert G Marx; Eric C McCarty; Richard D Parker; Rick W Wright; Kurt P Spindler Journal: Sports Health Date: 2011-01 Impact factor: 3.843
Authors: Camilo Partezani Helito; Marcelo Batista Bonadio; Riccardo Gomes Gobbi; Roberto Freire da Mota E Albuquerque; José Ricardo Pécora; Gilberto Luis Camanho; Marco Kawamura Demange Journal: Arthrosc Tech Date: 2015-06-01
Authors: Katharine Hollnagel; Brent M Johnson; Kelley K Whitmer; Andrew Hanna; Thomas K Miller Journal: Clin Orthop Relat Res Date: 2019-12 Impact factor: 4.176
Authors: J Kristopher Ware; Brett D Owens; Matthew R Akelman; Naga Padmini Karamchedu; Paul D Fadale; Michael J Hulstyn; Robert M Shalvoy; Gary J Badger; Braden C Fleming Journal: Am J Sports Med Date: 2018-02-05 Impact factor: 6.202
Authors: Clayton T Hodges; Trevor J Shelton; Cyrus P Bateni; Stephen S Henrichon; Alton W Skaggs; Robert D Boutin; Cassandra A Lee; Brian M Haus; Richard A Marder Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-02-27 Impact factor: 4.342
Authors: Lindsey M Spragg; Heather A Prentice; Andrew Morris; Tadashi T Funahashi; Gregory B Maletis; Rick P Csintalan Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-03-01 Impact factor: 4.342
Authors: Jean Baptiste Marchand; Nicolas Ruiz; Augustin Coupry; Mark Bowen; Henri Robert Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-04-26 Impact factor: 4.342