Tearing an anterior cruciate ligament (ACL) graft is a devastating occurrence after ACL reconstruction (ACLR). Identifying and understanding the independent predictors of ACLR graft failure is important for surgical planning, patient counseling, and efforts to decrease the risk of graft failure.

Types of grafts

Patient’s with a torn ACL who are undergoing ACL reconstruction have a few different options on ACL grafts. It’s important that you understand what is best for you. The two different choices you’ll have are:

Autograft:The patient’s own hamstring or patellar tendon can be used.

Allograft:This is where  a donor tendon can be used.

Risk factors for graft failure

After going through ACL reconstruction surgery, one of the possible complications is ACL graft failure. Recent studies have looked at multiple variables including:

• graft type
• gender
• age
• body mass index (BMI)
• activity level
• presence of a concurrent meniscal tear
• primary vs. revision surgery

They found that the two biggest risk factors for ACL graft failure were age and graft type. So how does that effect you?

Where do you fit in

Patients age 10-19 years old were at highest risk for graft failure. Patients who received allograft were also at significantly increased risk for graft failure. Therefore, young active patients are more likely to have favorable outcomes when using an autograft for their ACL reconstruction.

Of course, every patient should still discuss the right graft for their case with their physician. Other factors to consider with allograft is there is no harvest site that needs to heal, there is less post-op pain, and easier rehab.