Increased rerupture rate in younger patients following hamstrings anterior cruciate ligament reconstruction: Mid-term results

BACKGROUND: Several studies observed that younger athletes reported higher rates of second anterior cruciate ligament (ACL) injury. The aim of this study was to retrospectively evaluate ACL rerupture rate in a large cohort of patients who underwent primary ACL reconstruction using hamstring tendon autografts. The hypothesis was that primary ACL reconstruction with hamstring tendon autografts confirmed satisfying results and that younger age could represent a risk factor leading to a higher ACL rerupture rate. METHODS: Two hundred forty-six patients who underwent primary ACL reconstruction between 2004 and 2012 were successfully contacted from senior author’s database after an average follow-up of 10.9 years (range, 7 to 15 years) and they agreed to participate the study. Retrospective chart review was performed for all patients to evaluate variables of age, sex and mechanism of injury. Patients were asked about any subsequent ipsilateral knee ACL injury and/or reoperation. In case they underwent rerupture of the ACL, information about timing from primary surgery were obtained. RESULTS: In 15 patients rerupture occurred. In 12 cases, this was due to a new injury following sports participation. Re-tear occurred mostly in patients practicing soccer and basketball. Patients in the age group <25 years reported the highest rerupture rate (10/77, 12.9%) compared to older patients (P<0.05). CONCLUSIONS: The current study confirms a low re-injury rate following primary single-bundle ACL reconstruction with hamstring tendon autografts. Most patients who sustained re-injury were 25 years or younger; thus, supporting the observation that younger age represents a risk factor leading to repeat ACL rupture.