This prospective MOON cohort study analyzed 2488 patients with minimum 2-year follow-up after primary ACL reconstruction to identify independent risk factors for both ipsilateral graft failure and contralateral native ACL tear, using multivariable logistic regression controlling for age, sex, activity level, graft type, meniscal status, and sport.
When counseling a young, highly active patient about graft choice, emphasize that allograft carries roughly 5× the retear risk of BTB autograft in this age group — a difference that becomes negligible by the mid-30s.
Age and Marx activity score are your two most powerful predictors of reinjury for both knees; sex, sport, and meniscal status should not independently alter your risk conversation.
This prospective MOON cohort study analyzed 2488 patients with minimum 2-year follow-up after primary ACL reconstruction to identify independent risk factors for both ipsilateral graft failure and contralateral native ACL tear, using multivariable logistic regression controlling for age, sex, activity level, graft type, meniscal status, and sport.
When counseling a young, highly active patient about graft choice, emphasize that allograft carries roughly 5× the retear risk of BTB autograft in this age group — a difference that becomes negligible by the mid-30s.
Age and Marx activity score are your two most powerful predictors of reinjury for both knees; sex, sport, and meniscal status should not independently alter your risk conversation.