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Higher Return To Pre-Injury Activity Levels Following ACL Reconstruction With Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft In High Activity Patients: Results From The New Zealand ACL Registry

Simon W. Young, MD, FRACS
NEW ZEALAND

Higher Return To Pre-Injury Activity Levels Following ACL Reconstruction With Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft In High Activity Patients: Results From The New Zealand ACL Registry

Simon W. Young, MD, FRACS, NEW ZEALAND Richard Rahardja, MBChB, BMedSc(Hons), NEW ZEALAND Mark G. Clatworthy, FRACS, NEW ZEALAND Paul Monk, DPhil (Oxon), FRCS, NEW ZEALAND Hamish Love, FRACS, NEW ZEALAND

University Of Auckland, Auckland, NEW ZEALAND

2021 Congress Abstract Presentation 6 minutes Not yet rated

Anatomic Location

Knee

Anatomic Structure

Ligaments

Diagnosis / Condition

Instability

Treatment / Technique

Repair / Reconstruction

Ligaments

ACL

Sports Medicine

Epidemiology Evidence Based Medicine Outcome Studies

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Summary: The use of a BTB autograft increased the odds of a return to pre-injury activity level at 2 years following ACL reconstruction.

Background

In primary anterior cruciate ligament (ACL) reconstruction, a bone-patellar tendon-bone (BTB) autograft is associated with lower ipsilateral failure rates. BTB grafts are associated with a higher rate of contralateral ACL injury, which some clinicians view as a marker of success of the BTB graft. However, there is a lack of evidence on whether BTB grafts improve the rate of return to activity and sport.

Purpose

To compare the rate of return to pre-injury activity levels between the BTB autograft and the hamstring tendon autograft in high activity patients.
Study Design: Cohort Study.

Methods

This study followed a high-activity (pre-injury Marx score >12) cohort of 1,844 patients who underwent primary ACL reconstruction between 2014 and 2018. Prospectively collected data from the New Zealand ACL Registry, including pre-injury and post-operative Marx activity scores, were analyzed. The proportion of patients who returned to their pre-injury activity level at 1- and 2-year follow-up were compared between graft types.

Results

Overall, 11.3% (208 out of 1,844) of patients returned to their pre-injury activity level at 1-year follow-up, while 15.5% (184 out of 1,190) returned at 2-year follow-up. At 1-year follow-up, 17.2% of patients with a BTB autograft returned to their pre-injury activity level compared to 9.3% of patients with a hamstring tendon autograft (adjusted OR = 1.59, 95% CI 1.17 – 2.17, p = 0.003). At 2-year follow-up, 23.3% of BTB patients returned to their pre-injury level compared to 13.3% of hamstring tendon patients (adjusted OR = 1.63, 95% CI 1.14 – 2.34, p = 0.008). Male sex and younger age were associated with a higher return to activity at both follow-up timepoints.

Conclusion

The use of a BTB autograft increased the odds of a return to pre-injury activity level at early follow-up. A higher return to activity is a possible explanation for the higher rate of contralateral ACL injury with BTB autograft use.

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Effect Of Graft Choice On 6-Year Outcomes Of Revision Anterior Cruciate Ligament Reconstruction In The Multicenter ACL Revision Study (Mars) Cohort Abstract Presentation 6 minutes Rick W. Wright, MD, UNITED STATES
Predicting Subjective Failure of ACL Reconstruction: A Machine Learning Analysis of the Norwegian Knee Ligament Register and Patient Reported Outcomes Award Winner 5 minutes R. Kyle Martin, MD, FRCSC, UNITED STATES Solvejg Wastvedt, BA, UNITED STATES Ayoosh Pareek, MD, UNITED STATES Andreas Persson, MD, PhD, NORWAY Havard Visnes, MD, PT, PhD, NORWAY Anne Marie Fenstad, MSc, NORWAY Gilbert Moatshe, MD, PhD, NORWAY Julian Wolfson, PhD, UNITED STATES Lars Engebretsen, MD, PhD, NORWAY
MRI After ACL Reconstruction Demonstrates that Hamstring Grafts Heal and Integrate at Different Rates Abstract Presentation 6 minutes Sven Edward Putnis, MB ChB FRCS(Tr&Orth), UNITED KINGDOM Takeshi Oshima, MD, PhD, JAPAN Antonio Klasan, MD, PhD, EMBA, FRCS, AUSTRIA Samuel Grasso, PhD, B. Engineering (Mechanical), AUSTRALIA Thomas Neri, MD, PhD, Prof., FRANCE Myles R. J. Coolican, FRACS, AUSTRALIA Brett A. Fritsch, MBBS BSc(Med), FRACS, FAOrthA, AUSTRALIA David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA
Coach Education Improves Implementation Of ACL Injury Prevention Programs: A Cluster-Randomized Controlled Trial Abstract Presentation 5 minutes Daphne Ling, PhD, MPH, TAIWAN Caroline Boyle, UNITED STATES Brandon Schneider, MS, UNITED STATES Joseph Janosky, DrPHc, MS, PT, ATC, UNITED STATES James Kinderknecht, UNITED STATES Robert G. Marx, MD, UNITED STATES
Local Anaesthetic Infiltration (Lia) Is Equally Effective As Adductor Nerve Blocks For Pain Relief In Anterior Cruciate Ligament (Acl) Reconstructions. Abstract Presentation 8 minutes Mohammad Abou Salhab, MBChB, MSc, UNITED KINGDOM Sonal Sonwalkar , FRCA, UNITED KINGDOM Sanjeev Anand, MD, UNITED KINGDOM Martin Stone, MD, UNITED KINGDOM
Xenograft For Anterior Cruciate Ligament Reconstruction Was Associated With High Graft Processing Infection. Abstract Presentation 6 minutes Willem M. van der Merwe, MBChB, FCS(SA)Ortho, SOUTH AFRICA Martin Lind, MD, PhD, Prof., DENMARK Peter Faunoe, MD, DENMARK Kees van Egmond, MD, NETHERLANDS Stefano Zaffagnini, MD, Prof., ITALY Maurilio Marcacci, MD, ITALY Ramon Cugat Bertomeu, MD, PhD, SPAIN Rene E. Verdonk, Prof Em, MD, PhD, BELGIUM Ernique Ibanez, MD, PhD, SPAIN Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Concurrent Treatment Of A Displaced Bucket Handle And Anterior Cruciate Ligament Reconstruction: A Higher Risk Of Stiffness? Abstract Presentation 5 minutes Etienne Deroche, MD, FRANCE Cécile Batailler, MD, PhD, FRANCE John Swan, MBBS, FRANCE Sebastien Lustig, MD, PhD, Prof., FRANCE Elvire Servien, MD, PhD, Prof., FRANCE
Predicting Subsequent Revision ACL Reconstruction: A Machine Learning Analysis of the Norwegian Knee Ligament Register Abstract Presentation 5 minutes R. Kyle Martin, MD, FRCSC, UNITED STATES Solvejg Wastvedt, BA, UNITED STATES Ayoosh Pareek, MD, UNITED STATES Andreas Persson, MD, PhD, NORWAY Havard Visnes, MD, PT, PhD, NORWAY Anne Marie Fenstad, MSc, NORWAY Gilbert Moatshe, MD, PhD, NORWAY Julian Wolfson, PhD, UNITED STATES Lars Engebretsen, MD, PhD, NORWAY
Value, Limitations And Recommendations For Use Of Metal-Reduction Knee MRI Sequences Following Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Brandon Zhao, MD, CANADA Nabil Khan, MBChB, MMED, FCS Orth, CANADA Mark F. Sommerfeldt, MD, CANADA Anukul Panu, MD, CANADA Jacob L Jaremko, MD, PhD, CANADA Catherine May Ting Hui, MD, FRCSC, CANADA
Acl - Pcl Fixation Sequence During Multi-Ligament Knee Reconstruction Does Not Affect Knee Laxity Abstract Presentation 6 minutes Carola F. van Eck, MD, PhD, FAAOS, UNITED STATES Aly Maher Fayed, MD, EGYPT Ryo Kanto, MD, JAPAN Taylor M. Price, MS, UNITED STATES Michael Dinenna, BS, UNITED STATES Monica A. Linde, MSIE, RN, UNITED STATES Patrick J. Smolinski, PhD, UNITED STATES

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Higher Return To Pre-Injury Activity Levels Following ACL Reconstruction With Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft In High Activity Patients: Results From The New Zealand ACL Registry

Higher Return To Pre-Injury Activity Levels Following ACL Reconstruction With Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft In High Activity Patients: Results From The New Zealand ACL Registry

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Purpose

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Conclusion

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Higher Return To Pre-Injury Activity Levels Following ACL Reconstruction With Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft In High Activity Patients: Results From The New Zealand ACL Registry

Higher Return To Pre-Injury Activity Levels Following ACL Reconstruction With Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft In High Activity Patients: Results From The New Zealand ACL Registry

Background

Purpose

Methods

Results

Conclusion

More ISAKOS 2021: Global Content