Reconstruction of the anterior cruciate ligament: association of graft choice with increased risk of early revision

G B Maletis, M C S Inacio, J L Desmond, T T Funahashi

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115 Citations (Scopus)


We examined the association of graft type with the risk of early revision of primary anterior cruciate ligament reconstruction (ACLR) in a community-based sample. A retrospective analysis of a cohort of 9817 ACLRs recorded in an ACLR Registry was performed. Patients were included if they underwent primary ACLR with bone-patellar tendon-bone autograft, hamstring tendon autograft or allograft tissue. Aseptic failure was the main endpoint of the study. After adjusting for age, gender, ethnicity, and body mass index, allografts had a 3.02 times (95% confidence interval (CI) 1.93 to 4.72) higher risk of aseptic revision than bone-patellar tendon-bone autografts (p < 0.001). Hamstring tendon autografts had a 1.82 times (95% CI 1.10 to 3.00) higher risk of revision compared with bone-patellar tendon-bone autografts (p = 0.019). For each year increase in age, the risk of revision decreased by 7% (95% CI 5 to 9). In gender-specific analyses a 2.26 times (95% CI 1.15 to 4.44) increased risk of hamstring tendon autograft revision in females was observed compared with bone-patellar tendon-bone autograft. We conclude that allograft tissue, hamstring tendon autografts, and younger age may all increase the risk of early revision surgery after ACLR.

Original languageEnglish
Pages (from-to)623-8
Number of pages6
JournalBone and Joint Journal
Issue number5
Publication statusPublished or Issued - May 2013


  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anterior Cruciate Ligament
  • Anterior Cruciate Ligament Injuries
  • Anterior Cruciate Ligament Reconstruction
  • Bone-Patellar Tendon-Bone Grafting
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Registries
  • Reoperation
  • Retrospective Studies
  • Tendons
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Young Adult
  • Journal Article

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