Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 27;16(2):e55069.
doi: 10.7759/cureus.55069. eCollection 2024 Feb.

The Correlation Between Graft Size and Graft Failure in Hamstring Autograft Anterior Cruciate Ligament Reconstruction

Raed Y Abudaqqa  1 , Amgad M Elsheoibi  2 , Ali J Al Mas  1 , Kariyal P Arun  1 , Faris A Shaaban  1 , Khalid A Aliessa  1
Affiliations

The Correlation Between Graft Size and Graft Failure in Hamstring Autograft Anterior Cruciate Ligament Reconstruction

Raed Y Abudaqqa et al. Cureus. .

Abstract

Background: Previous studies have investigated various factors that contribute to graft failure in hamstring anterior cruciate ligament (ACL) reconstruction. However, there is debate about the potential advantages of increasing graft diameters beyond 8 mm.

Methods: In this retrospective cohort study (level of evidence III), we investigated whether increasing graft sizes beyond 8 mm diameter showed any advantages in reducing the risk of graft failure. We utilized univariate Kaplan-Meier analysis and Cox proportional hazard (PH) regression models to compare the risk of failure in the different patient groups. Mutual adjustment was performed for age, gender, body mass index (BMI), and graft strands. Graft sizes ranging between 8 and 10 mm were assessed for their association with graft failure, alongside examining the impact of graft strands, age, and BMI on graft failure.

Results: A total of 487 patients underwent hamstring autograft ACL reconstruction at our hospital between January 2016 and December 2020. Our analysis indicated that among patients undergoing hamstring autograft ACL reconstruction, the risk of graft failure was 1.64 times higher for patients with a graft size between 8.5 and 9 mm (95% CI 0.36-7.43, p=0.483) and 2.19 times higher for patients with a graft size between 9.5 and 10.5 mm (95% CI 0.42-11.31, p=0.384) compared to those with an 8 mm graft. However, there was weak evidence against the null hypothesis. Conclusion: These findings suggest that there is no benefit to increasing graft sizes past 8 mm and that other factors, like surgical technique, should be considered when assessing the risk of graft failure in patients undergoing ACL reconstruction.

Keywords: acl; anterior cruciate ligament reconstruction; arthroscopy; graft failure; hamstring autograft.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Survival function plotted for adjusted Cox PH model stratified by graft size
PH: proportional hazard
Figure 2
Figure 2. Failure function plotted for adjusted Cox PH model stratified by graft strands
PH: proportional hazard
See this image and copyright information in PMC

References

    1. Trends in incidence of ACL reconstruction and concomitant procedures among commercially insured individuals in the United States, 2002-2014. Herzog MM, Marshall SW, Lund JL, Pate V, Mack CD, Spang JT. Sports Health. 2018;10:523–531. - PMC - PubMed
    1. Is anterior cruciate ligament reconstruction effective in preventing secondary meniscal tears and osteoarthritis? Sanders TL, Kremers HM, Bryan AJ, et al. Am J Sports Med. 2016;44:1699–1707. - PubMed
    1. Long-term follow-up of isolated ACL tears treated without ligament reconstruction. Sanders TL, Pareek A, Kremers HM, et al. Knee Surg Sports Traumatol Arthrosc. 2017;25:493–500. - PubMed
    1. The Scandinavian ACL registries 2004-2007: baseline epidemiology. Granan LP, Forssblad M, Lind M, Engebretsen L. Acta Orthop. 2009;80:563–567. - PMC - PubMed
    1. The first results from the Danish ACL reconstruction registry: epidemiologic and 2 year follow-up results from 5,818 knee ligament reconstructions. Lind M, Menhert F, Pedersen AB. Knee Surg Sports Traumatol Arthrosc. 2009;17:117–124. - PubMed

LinkOut - more resources