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Related Experiment Video

Updated: Dec 31, 2025

Surgical Retrieval, Isolation and In vitro Expansion of Human Anterior Cruciate Ligament-derived Cells for Tissue Engineering Applications
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Risk Factors for Requiring a Revision Anterior Cruciate Ligament Reconstruction: A Case-Control Study.

Todd P Pierce1, Jennifer Kurowicki1, John J Kelly2

  • 1Department of Orthopaedic Surgery, St. Joseph's University Medical Center, Paterson, New Jersey.

The Journal of Knee Surgery
|December 31, 2019
PubMed
Summary
This summary is machine-generated.

Graft choice significantly impacts revision anterior cruciate ligament (ACL) reconstruction rates, with allografts showing higher risks than bone-tendon-bone autografts. Patient demographics and sports did not influence revision likelihood.

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Area of Science:

  • Orthopaedic Surgery
  • Sports Medicine
  • Biomedical Engineering

Background:

  • Anterior cruciate ligament (ACL) reconstruction aims to restore knee function but revision surgeries are sometimes necessary.
  • Identifying risk factors for revision ACL reconstruction is crucial for improving patient outcomes.
  • Previous studies suggest various factors may influence ACL graft success, necessitating further investigation.

Purpose of the Study:

  • To evaluate the association between patient demographics, family history, graft choice, sport, and mechanism of injury with the need for revision ACL reconstruction.
  • To identify specific risk factors that increase the likelihood of requiring a second ACL surgery.
  • To inform clinical decisions regarding graft selection and patient management to minimize revision rates.

Main Methods:

  • Retrospective review of primary ACL reconstructions performed between 2012 and 2016 at a single institution.
  • Analysis of 312 patients (mean age 24 years) with a mean follow-up of 4 years.
  • Comparison of demographic data, family history, graft type (allograft vs. autograft), sport, and injury mechanism between patients who underwent revision and those who did not.

Main Results:

  • A total of 19 patients (6.1%) required revision ACL reconstruction.
  • Graft choice was a significant factor: tibialis anterior and hamstring allografts had substantially higher revision rates compared to bone-tendon-bone (BTB) patella autografts.
  • No significant association was found between gender, age, family history, or sport played and the risk of revision surgery. Contact injuries showed a trend towards higher revision rates.

Conclusions:

  • Graft selection is a critical determinant of revision ACL reconstruction rates, with allografts associated with a higher risk than BTB patellar autografts.
  • Demographic factors, family history, and sport do not appear to be significant predictors of revision surgery.
  • Understanding these risk factors can help optimize surgical planning and graft choice to improve long-term outcomes after ACL reconstruction.