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Risk factors for ACL revision failure and optimum graft size for revision anterior cruciate ligament reconstruction

  • 0Chinese University of Hong Kong, Sha Tin, Hong Kong, China. victorluwawa@yahoo.com.hk.
European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie +

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June 19, 2025

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June 19, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Graft diameter less than 9 mm and returning to pivoting sports after revision anterior cruciate ligament reconstruction (ACLR) increase the risk of graft re-rupture. Meniscus and chondral pathologies were not associated with re-rupture.

Area Of Science

  • Orthopedic Surgery
  • Sports Medicine
  • Biomedical Engineering

Background

  • Graft re-rupture is a significant complication following revision anterior cruciate ligament reconstruction (ACLR).
  • Limited literature exists on risk factors for graft re-rupture, particularly concerning graft size in revision ACLR.
  • This study investigates risk factors for graft re-rupture and optimal graft diameter in revision ACLR.

Purpose Of The Study

  • To identify risk factors associated with graft re-rupture after revision ACLR.
  • To determine the optimal graft diameter for revision ACLR to minimize re-rupture rates.
  • To evaluate the influence of concomitant intra-articular pathologies on revision ACLR outcomes.

Main Methods

  • Retrospective review of 132 patients undergoing revision ACLR between 2013 and 2021.
  • Analysis of patient demographics, operative variables, and graft characteristics.
  • Logistic regression models used to identify independent risk factors for graft re-rupture, including graft diameter and return to sport.

Main Results

  • The overall graft re-rupture rate was 16.7%.
  • A graft diameter less than 9 mm (OR: 3.873) and return to pivoting sports (OR: 4.105) were identified as significant risk factors for graft re-rupture.
  • Concomitant medial or lateral meniscus pathology and chondral lesions were not associated with increased re-rupture rates.

Conclusions

  • Graft diameter < 9 mm and return to pivoting sports are significant risk factors for graft re-rupture after revision ACLR.
  • Meniscus pathology and chondral lesions do not appear to increase the risk of graft re-rupture in revision ACLR.
  • Findings suggest optimizing graft diameter and considering patient activity levels to improve revision ACLR outcomes, warranting further multi-center investigation.

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