Females Under Age 25 at Higher Risk for ACL Re-Tear

    Graft size, sex, and age have a significant effect on the odds of an anterior cruciate ligament (ACL) re-tear post-reconstruction with a hamstring graft, according to research presented at the American Orthopaedic Society of Sports Medicine’s recent Annual Meeting in Colorado Springs, Colorado.

    “Our research noted that female patients under the age of 25 with a graft size of less than 8 mm have an increased chance of re-tearing their ACL following reconstruction,” said lead author Duong Nguyen, MD.

    “Another contributing issue to this increased re-tear rate might also be due to pre-disposing factors, including estrogen levels, anatomical differences, and decreased knee strength. More research is needed to further determine the exact causes.”

    Dr. Nguyen and his team studied a cohort of 503 athletes undergoing primary autograft hamstring ACL reconstruction. The surgeries were all performed at a single center by a single surgeon between September and December 2012 and were followed for 2 years.

    The average age of the athletes was 27, with 235 females and 268 males taking part in the study. The same surgical technique was used during all of the procedures.

    Patients were allowed to return to sports participation between 6 and 12 months post-surgery only if they were pain-free, had equal quadriceps/hamstring strength, and had graduated from the rehabilitation program.

    “Given the results of our study, we feel that surgeons should counsel their younger, female patients accordingly and consider modifying their surgical techniques to utilize larger size grafts and/or rehabilitation strategies to lessen the chance of a re-tear,” Dr. Nguyen said.