ACL Reconstruction in Patients Under Age 25: Outcome and Failure Rates of Autograft and Allograft (SS-11)

Abstract

To assess failure rates of autograft and allograft ACL reconstruction in patients under age 25 to optimize future graft selection. A retrospective review was performed of 108 patients under age 25 who underwent ACL reconstruction at a single institution from 2005-2010 to determine failure rates for autograft and allograft ACL reconstruction. Lysholm, Tegner, and IKDC outcome scores were obtained in 44 patients. Mean follow-up was 47.4 months (range 24-74) and 42 months (range, 19-70) for autograft and allograft, respectively. Sixty-two patients underwent autograft ACL reconstruction. Failure occurred in 2 of 28 (7.1%) BPTB patients and 5 of 34 (14.7%) hamstring patients. The difference in autograft failure rate approached significance (p = 0.05). Forty-six patients underwent allograft ACL reconstruction. Failure occurred in 6 patients (13%), including 3 anterior tibialis (15.8%) and 2 Achilles tendon allograft patients (11.1%). Differences in allograft failure rates did not reach statistical significance (p > 0.05). With regard to age and gender, ten of the thirteen failures were females, including all five hamstring autograft failures. In addition, nine of the ten failures in females occurred in patients under age 17. No failures occurred in patients over age 21. Among specific graft choices, failure rates were lowest for BPTB autograft and highest for hamstring autograft. Graft failure occurred more often in young female patients. Caution is advised when selecting hamstring autograft, especially for young females in highly competitive sports.