Objective: Recently techniques have been developed to increase graft diameter in hamstring ACL reconstruction with the hope to decrease graft failure. To date there is limited evidence to show that a smaller graft diameter results in a higher ACL failure rate. Method: The factors for failure in 1480 consecutive single surgeon hamstring ACL reconstructions were evaluated prospectively. Patients were followed for 2-15 years. A multivariate analysis was performed which looked at graft size, age, sex, time to surgery, meniscal integrity, meniscal repair and ACL graft placement to determine whether graft diameter matters in determining the failure of hamstring ACL reconstruction. Results: Graft diameters ranged from 6-10 mm. The mean graft diameter for all patients was 7.75 mm. 83 ACL reconstructions failed. The mean size of graft failures was 7.55 mm ACL reconstructions that failed had a significantly smaller hamstring graft diameter p=0.001. The Hazard Ratio for a smaller diameter graft is 0.517 p=<0.0001. For every 1 mm decrease in graft diameter there is a 48.3% higher chance of failure. The multivariate analysis showed a hazard ratio of 0.543 p=0.002. For every 1 mm decrease in graft diameter there is a 45.7% higher chance of failure. Conclusion: Smaller diameter hamstring grafts do have a higher failure rate. Grafts ≤ 7.5 mm had twice the failure rate of grafts ≥8 mm using a multivariate analysis for every 1 mm decrease in graft diameter there is a 45.7% higher chance of failure.
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机译：目的：最近已开发出一些技术来增加绳肌ACL重建术中的移植物直径，以期减少移植物的失败。迄今为止，仅有有限的证据表明较小的移植物直径会导致较高的ACL失败率。方法：前瞻性评估了1480例连续的单次外科医生腿筋ACL重建的失败因素。随访患者2-15年。进行了多变量分析，研究了移植物的大小，年龄，性别，手术时间，半月板完整性，半月板修复和ACL移植物放置，以确定移植物直径是否对确定determining绳肌ACL重建失败具有重要意义。结果：接枝直径为6-10毫米。所有患者的平均移植物直径为7.75 mm。 83 ACL重建失败。移植失败的平均大小为7.55 mm ACL重建，失败的failed绳肌移植直径明显较小，p = 0.001。较小直径移植物的危害比为0.517 p = <0.0001。移植物直径每减少1 mm，失败的几率就会增加48.3％。多元分析表明，危险比为0.543 p = 0.002。移植物直径每减少1 mm，失败的几率就会增加45.7％。结论：较小直径的腿筋移植物确实有较高的失败率。使用多变量分析，移植直径≤7.5毫米的移植物失败率是≥8毫米的移植物的两倍，移植物直径每降低1毫米，失败的几率就增加45.7％。
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