Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Am J Sports Med. 2012 Apr;40(4):800-7. doi: 10.1177/0363546511432545. Epub 2012 Jan 11.
Anterior cruciate ligament (ACL) reconstruction is one of the most frequently performed orthopaedic procedures. Failures are a reality of surgery; to limit failures, we must first understand and quantify them.
The purposes of this study were to determine the rate and factors associated with graft failure after anatomic ACL reconstruction performed with allograft.
Case series; Level of evidence, 4.
All consecutive subjects who underwent anatomic single- or double-bundle ACL reconstruction with allograft between January 2007 and December 2009 were included and followed clinically. Graft failure was defined as patient-reported instability, pathological laxity during the physical examination, or evidence of a failed graft on magnetic resonance imaging or during arthroscopy. Potential predictors of graft failure that were explored included subject age, sex, height, weight, body mass index, meniscus injury, and time of return to preinjury sports.
There were 206 subjects included in this study: 168 double-bundle and 38 single-bundle reconstructions. Overall, 27 (13%) subjects experienced graft failure. Twenty-three (13%) double-bundle subjects failed. The characteristics associated with double-bundle graft failure were younger age (19 vs 25 years, P < .001) and earlier return to sports (at 222 vs 267 days, P = .007). Four (11%) of the single-bundle subjects failed. The characteristics associated with single-bundle graft failure were younger age (19 vs 24 years, P = .049) and increased body mass (83 vs 65 kg, P = .031).
The overall graft failure rate after anatomic ACL reconstruction with allograft was 13%. Younger age, earlier return to sports, and a higher body weight were associated with graft failure.
前交叉韧带（ACL）重建是最常进行的矫形手术之一。手术失败是手术的现实；为了限制失败，我们必须首先了解并量化它们。
本研究的目的是确定同种异体ACL 重建后移植物失败的发生率和相关因素。
病例系列；证据水平，4。
纳入 2007 年 1 月至 2009 年 12 月期间接受同种异体解剖学单束或双束 ACL 重建的所有连续患者，并进行临床随访。移植物失败定义为患者报告的不稳定、体检时病理性松弛或磁共振成像或关节镜检查显示移植物失败的证据。探讨的移植物失败的潜在预测因素包括患者年龄、性别、身高、体重、体重指数、半月板损伤以及恢复到受伤前运动的时间。
本研究共纳入 206 例患者：168 例双束和 38 例单束重建。总体而言，27 例（13%）患者发生移植物失败。23 例（13%）双束患者失败。与双束移植物失败相关的特征是年龄较小（19 岁与 25 岁，P <.001）和更早恢复运动（222 天与 267 天，P =.007）。4 例（11%）单束患者失败。与单束移植物失败相关的特征是年龄较小（19 岁与 24 岁，P =.049）和体重增加（83 千克与 65 千克，P =.031）。
同种异体解剖学 ACL 重建后移植物总体失败率为 13%。年龄较小、更早恢复运动和较高体重与移植物失败相关。
