Long-term rate of graft failure after ACL reconstruction: a geographic population cohort analysis
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 fa...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2017, Vol.25 (1), p.222-228 |
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| creator | Sanders, Thomas L. Pareek, Ayoosh Hewett, Timothy E. Levy, Bruce A. Dahm, Diane L. Stuart, Michael J. Krych, Aaron J. |
| description | 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
|
| doi_str_mv | 10.1007/s00167-016-4275-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1877844003</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4315215861</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-6eecdabb3af9d4179bdb63553326303f0c9d62285ed374af4c363afded4de10a3</originalsourceid><addsrcrecordid>eNqN0U1rGzEQBmBREhon6Q_opQh6yUXN6GNXVm_BJE3BkEtyFlpp1l6zXm2l3YP_fWScllIo5DISzDMjxEvIZw7fOIC-zQC81qwUpoSu2OEDWXAlJdNS6TOyAKMEE1DVF-Qy5x1AuSrzkVwULERlxIK4dRw2bMK0p8lNSGNLN8m1E21d188JabljonerNU3o45CnNPupi8N36ugGY8HjtvN0jOPcu2OD-riNaaJucP0hd_manLeuz_jp7bwiLw_3z6tHtn768XN1t2ZeQTWxGtEH1zTStSYork0TmlpWlZSiliBb8CbUQiwrDFIr1yov62IDBhWQg5NX5Oa0d0zx14x5svsue-x7N2Ccs-VLrZdKAch30MporpThhX79h-7inMrXjqo2aqm5hqL4SfkUc07Y2jF1e5cOloM9RmVPUdlS7DEqeygzX942z80ew5-J39kUIE4gl9awwfTX0__d-gpWrp9s</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1869487170</pqid></control><display><type>article</type><title>Long-term rate of graft failure after ACL reconstruction: a geographic population cohort analysis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Sanders, Thomas L. ; Pareek, Ayoosh ; Hewett, Timothy E. ; Levy, Bruce A. ; Dahm, Diane L. ; Stuart, Michael J. ; Krych, Aaron J.</creator><creatorcontrib>Sanders, Thomas L. ; Pareek, Ayoosh ; Hewett, Timothy E. ; Levy, Bruce A. ; Dahm, Diane L. ; Stuart, Michael J. ; Krych, Aaron J.</creatorcontrib><description>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.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-016-4275-y</identifier><identifier>PMID: 27522592</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Anterior Cruciate Ligament - surgery ; Anterior Cruciate Ligament Injuries - complications ; Anterior Cruciate Ligament Injuries - surgery ; Anterior Cruciate Ligament Reconstruction - methods ; Bone surgery ; Bone Transplantation ; Cohort analysis ; Cohort Studies ; Female ; Gender ; Graft Survival ; Hamstring Tendons - transplantation ; Humans ; Incidence ; Knee ; Knee Injuries - surgery ; Ligaments ; Longitudinal Studies ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Patellar Ligament - transplantation ; Patients ; Population ; Postoperative Complications - epidemiology ; Recurrence ; Retrospective Studies ; Tendons - transplantation ; Tibial Meniscus Injuries - complications ; Tibial Meniscus Injuries - surgery ; Transplantation, Autologous ; Transplantation, Homologous ; Young Adult</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017, Vol.25 (1), p.222-228</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016</rights><rights>Knee Surgery, Sports Traumatology, Arthroscopy is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-6eecdabb3af9d4179bdb63553326303f0c9d62285ed374af4c363afded4de10a3</citedby><cites>FETCH-LOGICAL-c405t-6eecdabb3af9d4179bdb63553326303f0c9d62285ed374af4c363afded4de10a3</cites><orcidid>0000-0001-7741-9692</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-016-4275-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-016-4275-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27522592$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sanders, Thomas L.</creatorcontrib><creatorcontrib>Pareek, Ayoosh</creatorcontrib><creatorcontrib>Hewett, Timothy E.</creatorcontrib><creatorcontrib>Levy, Bruce A.</creatorcontrib><creatorcontrib>Dahm, Diane L.</creatorcontrib><creatorcontrib>Stuart, Michael J.</creatorcontrib><creatorcontrib>Krych, Aaron J.</creatorcontrib><title>Long-term rate of graft failure after ACL reconstruction: a geographic population cohort analysis</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anterior Cruciate Ligament - surgery</subject><subject>Anterior Cruciate Ligament Injuries - complications</subject><subject>Anterior Cruciate Ligament Injuries - surgery</subject><subject>Anterior Cruciate Ligament Reconstruction - methods</subject><subject>Bone surgery</subject><subject>Bone Transplantation</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Gender</subject><subject>Graft Survival</subject><subject>Hamstring Tendons - transplantation</subject><subject>Humans</subject><subject>Incidence</subject><subject>Knee</subject><subject>Knee Injuries - surgery</subject><subject>Ligaments</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Patellar Ligament - transplantation</subject><subject>Patients</subject><subject>Population</subject><subject>Postoperative Complications - epidemiology</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Tendons - transplantation</subject><subject>Tibial Meniscus Injuries - complications</subject><subject>Tibial Meniscus Injuries - surgery</subject><subject>Transplantation, Autologous</subject><subject>Transplantation, Homologous</subject><subject>Young Adult</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqN0U1rGzEQBmBREhon6Q_opQh6yUXN6GNXVm_BJE3BkEtyFlpp1l6zXm2l3YP_fWScllIo5DISzDMjxEvIZw7fOIC-zQC81qwUpoSu2OEDWXAlJdNS6TOyAKMEE1DVF-Qy5x1AuSrzkVwULERlxIK4dRw2bMK0p8lNSGNLN8m1E21d188JabljonerNU3o45CnNPupi8N36ugGY8HjtvN0jOPcu2OD-riNaaJucP0hd_manLeuz_jp7bwiLw_3z6tHtn768XN1t2ZeQTWxGtEH1zTStSYork0TmlpWlZSiliBb8CbUQiwrDFIr1yov62IDBhWQg5NX5Oa0d0zx14x5svsue-x7N2Ccs-VLrZdKAch30MporpThhX79h-7inMrXjqo2aqm5hqL4SfkUc07Y2jF1e5cOloM9RmVPUdlS7DEqeygzX942z80ew5-J39kUIE4gl9awwfTX0__d-gpWrp9s</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>Sanders, Thomas L.</creator><creator>Pareek, Ayoosh</creator><creator>Hewett, Timothy E.</creator><creator>Levy, Bruce A.</creator><creator>Dahm, Diane L.</creator><creator>Stuart, Michael J.</creator><creator>Krych, Aaron J.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7741-9692</orcidid></search><sort><creationdate>2017</creationdate><title>Long-term rate of graft failure after ACL reconstruction: a geographic population cohort analysis</title><author>Sanders, Thomas L. ; Pareek, Ayoosh ; Hewett, Timothy E. ; Levy, Bruce A. ; Dahm, Diane L. ; Stuart, Michael J. ; Krych, Aaron J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-6eecdabb3af9d4179bdb63553326303f0c9d62285ed374af4c363afded4de10a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anterior Cruciate Ligament - surgery</topic><topic>Anterior Cruciate Ligament Injuries - complications</topic><topic>Anterior Cruciate Ligament Injuries - surgery</topic><topic>Anterior Cruciate Ligament Reconstruction - methods</topic><topic>Bone surgery</topic><topic>Bone Transplantation</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Gender</topic><topic>Graft Survival</topic><topic>Hamstring Tendons - transplantation</topic><topic>Humans</topic><topic>Incidence</topic><topic>Knee</topic><topic>Knee Injuries - surgery</topic><topic>Ligaments</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Patellar Ligament - transplantation</topic><topic>Patients</topic><topic>Population</topic><topic>Postoperative Complications - epidemiology</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Tendons - transplantation</topic><topic>Tibial Meniscus Injuries - complications</topic><topic>Tibial Meniscus Injuries - surgery</topic><topic>Transplantation, Autologous</topic><topic>Transplantation, Homologous</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sanders, Thomas L.</creatorcontrib><creatorcontrib>Pareek, Ayoosh</creatorcontrib><creatorcontrib>Hewett, Timothy E.</creatorcontrib><creatorcontrib>Levy, Bruce A.</creatorcontrib><creatorcontrib>Dahm, Diane L.</creatorcontrib><creatorcontrib>Stuart, Michael J.</creatorcontrib><creatorcontrib>Krych, Aaron J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sanders, Thomas L.</au><au>Pareek, Ayoosh</au><au>Hewett, Timothy E.</au><au>Levy, Bruce A.</au><au>Dahm, Diane L.</au><au>Stuart, Michael J.</au><au>Krych, Aaron J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term rate of graft failure after ACL reconstruction: a geographic population cohort analysis</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2017</date><risdate>2017</risdate><volume>25</volume><issue>1</issue><spage>222</spage><epage>228</epage><pages>222-228</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27522592</pmid><doi>10.1007/s00167-016-4275-y</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7741-9692</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017, Vol.25 (1), p.222-228 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1877844003 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Adult Anterior Cruciate Ligament - surgery Anterior Cruciate Ligament Injuries - complications Anterior Cruciate Ligament Injuries - surgery Anterior Cruciate Ligament Reconstruction - methods Bone surgery Bone Transplantation Cohort analysis Cohort Studies Female Gender Graft Survival Hamstring Tendons - transplantation Humans Incidence Knee Knee Injuries - surgery Ligaments Longitudinal Studies Male Medicine Medicine & Public Health Middle Aged Orthopedics Patellar Ligament - transplantation Patients Population Postoperative Complications - epidemiology Recurrence Retrospective Studies Tendons - transplantation Tibial Meniscus Injuries - complications Tibial Meniscus Injuries - surgery Transplantation, Autologous Transplantation, Homologous Young Adult |
| title | Long-term rate of graft failure after ACL reconstruction: a geographic population cohort analysis |
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