ArticleBMC musculoskeletal disorders2022
Young men are at higher risk of failure after ACL hamstring reconstructions: a retrospective multivariate analysis.
Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Smaller hamstrings autograft size after primary ACL reconstruction is associated with higher odds for graft failure: A meta-analysis on autografts sizes covering 46,268 patients.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Pooled it
- Anterior cruciate ligament reconstruction with six and eight-strand hamstring tendon autografts produces adequate graft dimensions and functional outcomes: A systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Predicting risk of unplanned subsequent knee surgery following ACL reconstruction.BMC musculoskeletal disorders · 2026Article
- Graft choice to decrease the revision rate of anterior cruciate ligament reconstruction: a nationwide retrospective cohort study.Scientific reports · 2024Article
- The Posterior Tibial Slope Is Not Associated With Graft Failure and Functional Outcomes After Anatomic Primary Isolated Anterior Cruciate Ligament Reconstruction.The American journal of sports medicine · 2023Article
- Early Complication Analysis of Dynamic Intraligamentary Stabilization versus Anterior Cruciate Ligament Reconstruction.Journal of personalized medicine · 2023Article
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6 authors.
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Abstract
backgroundResults of ACL reconstruction are influenced by both patient and surgical variables. Until now a significant amount of studies have focused on the influence of surgical technique on primary outcome, often leaving patient variables untouched. This study investigates the combined influence of patient and surgical variables through multivariate analysis.
methodsSingle-center retrospective cohort study. All patients who underwent primary ACL hamstring reconstruction within a 5-year period were included. Patient characteristics (gender, age, height, weight, BMI at time of surgery) and surgical variables (surgical technique, concomitant knee injury, graft diameter, type of femoral and tibial fixation) were collected. Patients were asked about Tegner Activity Scale (TAS), complications and revision surgery. Multivariate logistic regression was used to study risk factors. First graft failure and potential risk factors (patient and surgical) were univariately assessed. Risk factors with a p-value ≤ 0.05 were included in the multivariate model.
resultsSix hundred forty-seven primary ACL hamstring reconstructions were included. There were 41 graft failures (failure rate 6.3%). Patient gender, age, height and preoperative TAS had a significant influence on the risk of failure in the univariate analysis. The multivariate analyses showed that age and sex remained significant independent risk factors. Patients with a failed ACL reconstruction were younger (24.3 vs 29.4 years, OR 0.937), with women at a lower risk for failure of their ACL reconstruction (90.2% males vs 9.8% females, female OR 0.123). ACL graft diameter and other surgical variables aren't confounders for graft failure.
conclusionThis study shows that patient variables seem to have a larger influence on the failure rate of ACL hamstring reconstructive surgery than surgical variables. Identification of the right patient variables can help us make more informed decisions for our patients and create patient-specific treatment protocols. Young men's higher risk of failure suggests that these patients may benefit from a different reconstruction technique, such as use of a patellar tendon or combined ligament augmentation. LEVEL OF EVIDENCE: Retrospective cohort III.
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