Influence of graft diameter on patient reported outcomes after hamstring autograft anterior cruciate ligament reconstruction

Several studies have identified graft diameter as a risk factor for failure following anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to evaluate the effect of graft diameter on patient reported outcome measures (PROMS) following ACLR. We performed a retrospective review of prospectively collected data using a global surgical registry. 153 of 287 patients (53.3%) had complete data for each timepoint. Effect of graft diameter, graft type, femoral tunnel drilling technique, patient age, sex, and body mass index were evaluated. At 1-year post-operatively, a 1-mm increase in graft diameter was found to correlate with a 5.7-point increase in the Knee Injury and Osteoarthritis Outcome Score (KOOS) activity of daily living score (P=0.01), a 10.3-point increase in the sport score (P=0.003), and a 9.8-point increase in the quality of life score (P=0.013). At 2- years post-operatively, a 1-mm increase in graft size was found to be marginally correlated with KOOS symptoms and sport scores. Patients undergoing hamstring autograft ACLR, increasing graft diameter can result in improved PROMS, specifically improved KOOS subscale scores at 1 and 2- years post-operative.