2025 ISAKOS Biennial Congress ePoster
Smaller Hamstrings Autograft Size After Acl Reconstruction Is Associated With Higher Odds For Graft Failure: A Meta-Analysis On Autografts Sizes Covering 45,572 Patients After Primary Acl Reconstruction
Rebecca Simonsson, PT, MSc, Västra Frölunda SWEDEN
Kevin Teow, MD, Gothenburg SWEDEN
Johan Högberg, PT, MSc, Gothenburg SWEDEN
Janina Kaarre, MD MSc, Pittsburgh, PA UNITED STATES
Thorkell Snaebjörnsson, MD, Reykjavik ICELAND
Volker Musahl, MD, Prof., Pittsburgh, Pennsylvania UNITED STATES
Kristian Samuelsson, Prof, MD, PhD, MSc, Mölndal, Västra Götalands län SWEDEN
Eric Hamrin Senorski, PT, PhD, Assoc. Prof., Västra Frölunda SWEDEN
University of Gothenburg, Gothenburg, SWEDEN
FDA Status Not Applicable
Summary
With a low certainty of evidence, patients with greater HT autograft size have lower odds for graft failure compared with smaller HT autograft size.
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Abstract
Purpose
To conduct a systematic review and meta-analysis on graft size for the hamstrings tendon- (HT), patellar tendon- (PT) and quadriceps tendon (QT) autograft and evaluate odds for graft failure.
Methods
Medline, PubMed, Cochrane Library, Embase, Amed, and Web of Science were searched at three separate time points. Eligible studies had included patients who had undergone primary ACLR with (graft failures) or without (survivals) graft failure and had specified graft size for primary ACLR. Standardized mean differences were calculated for continuous variables, and odds ratios expressed with 95% confidence interval for the dichotomous variables of graft size for survivals versus graft failures. Risk of bias was assessed with RoBANS 2. Certainty of evidence was assessed with GRADE.
Results
A total of 45,572patients of which 43,261 HT, 2,311 PT were covered in the included 31 articles. An HT autograft size of ≥7 mm had 45% lower odds for a graft failure compared to <7 mm (p = 0.01), ≥8 mm HT autograft size had 26% lower odds for a graft failure compared to <8 mm (p=0.0002), ≥9 mm HT autograft size had 23% lower odds for a graft failure compared to <9 mm (p=0.0008) and, ≥10 mm HT autograft size had 31% lower odds for a graft failure compared to <10 mm (p=0.03). No significant odds for a graft failure were observed for patients with >10 mm compared to ≤10 mm or for patients with PT autograft.
Conclusion
With a low certainty of evidence, patients with greater HT autograft size have lower odds for graft failure compared with smaller HT autograft size. No significant difference in odds for graft failure was found for different PT autograft sizes.