Association of the Graft Size and Arthrofibrosis in Young Patients After Primary Anterior Cruciate Ligament Reconstruction

• Published in: Journal of the American Academy of Orthopaedic Surgeons Vol. 26; no. 23; p. e483
• Main Authors: Su, Alvin W, Storey, Eileen P, Lin, Shuai-Chun, Forst, Benjamin, Lawrence, J Todd, Ganley, Theodore J, Wells, Lawrence
• Format: Journal Article
• Language: English
• Published: United States 01.12.2018
• Subjects: Adolescent; Allografts - anatomy & histology; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction - adverse effects; Anterior Cruciate Ligament Reconstruction - methods; Athletic Injuries - surgery; Autografts - anatomy & histology; Body Mass Index; Case-Control Studies; Female; Fibrosis; Humans; Joint Diseases - etiology; Joint Diseases - pathology; Male; Postoperative Complications - pathology; Retrospective Studies; Risk Factors; Time Factors
• ISSN: 1940-5480
• DOI: 10.5435/JAAOS-D-17-00177

This study investigated the association of graft-related surgical factors and patient characteristics with the odds of arthrofibrosis after primary anterior cruciate ligament reconstruction (ACL-R). A retrospective case-control study assessed consecutive patients who underwent primary ACL-R in one tertiary pediatric hospital. Each arthrofibrosis case was matched to three controls for sex, calendar year, and age at the time of ACL-R, as well as the primary surgeon. Conditional multivariable logistic regression assessed the independent association of graft diameter, time from injury to ACL-R, concomitant knee pathologies, and body mass index. Twenty arthrofibrosis cases of 1,121 ACL-R patients (incidence 1.8%) were matched to 60 controls resulting in the mean age of 14.5 years. An increase of 1 mm graft diameter was associated with 3.2-times increased odds of arthrofibrosis. Other variables were not independently associated with arthrofibrosis. For young patients, the decision on the graft size must consider the possibility of arthrofibrosis with a larger graft versus reinjury with a smaller graft.