Clinical Comparison of Patients Undergoing Anterior Cruciate Ligament Reconstruction Using an Allograft or Autograft (original) (raw)
Related papers
2015
Background: Considering high incidence of anterior cruciate ligament (ACL) reconstruction using autograft or allograft for replacement of ACL ruptures, the present study was designed to compare the treatment results of allograft and autograft in ACL reconstruction. Methods: In this cross-sectional study, 58 cases with isolated ACL reconstruction (20 cases with allograft, 38 with autograft) were evaluated using the stability tests of International Knee Documentation Committee (IKDC) and Lysholm knee questionnaire, and mean range of motion (ROM), clinical results for Lachman and pivot-shift tests. Results: Mean ages for allograft group was 27.45(24-38) years and in autograft group 30.21(21-49). There was no statistically significant difference in both groups regarding to performed tests. Conclusion: Based on the achieved results and similar treatment outcomes for autograft and allograft groups, use of allograft for reconstruction of ACL is recommended.
2021
The aim of this study was to compare the effectiveness of tibialis anterior allografting and hamstring tendon autografting reconstruction surgery after anterior cruciate ligament (ACL) injury in adult patients. Patients and Methods: This study was designed as a cross-sectional and retrospective study. Preoperative and postoperative functional parameters of patients who underwent ACL reconstruction surgery with hamstring autograft and tibialis anterior allograft methods due to ACL rupture were compared. Cross-pin and screw-staple were used for femur and tibia fixations, respectively. Lysholm knee scoring scale (LKSS) and Tegner activity level scale (TALS) were used for the outcome measures. Results: A total of 121 patients (100 males, 21 females) with a mean age of 32.74±7.82 years (ranging from 19 to 52 years) were included. Pain and giving way phenomenon were the most common symptoms. There was a significant difference between the preoperative (32.7±7.8) and postoperative (64.08±7.8) LKSS values of all patients (p <0.001). A significant difference was found between the preoperative (2.37±1.2) and postoperative (5.52±1.4) TALSvaluesof all patients (p<0.001). Compared with preoperative and postoperative LKSS and TALS scores, the increase in the allograft group was more prominent (LKSS: 30.27±4.8 vs. 24.43±2.8, TALS: 3.32±1.1 vs. 2.84±0.8). Complications were observed in 5 patients (4.1%), and all of them were successfully treated. Conclusion: In the light of our study, both hamstring autograft method and allograft method seem to be effective in improving LKSS and TALS inpatients who underwent ACL reconstruction surgery. However, the improvement in the allograft group is more prominent than that of in the autograft group.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 1996
Seventy-eight of 113 consecutive patellar tendon anterior cruciate ligament reconstructions (autograft, 47 of 66; allograft, 31 of 47) were evaluated at an average of 34 months. Reconstructions were compared with Lysholm and Tegner knee-rating scales, physical examination findings, instrumented laxity values, single-leg hop distances, and isokinetic strength results. Lysholm scores > or = 90 were achieved by 69% of autograft patients versus 67% of allograft patients. Desired Tegner activity scores were achieved by 80% of autograft patients versus 74% of allograft patients. Patellofemoral signs and symptoms were absent in 40% of autograft patients versus 44% of allograft patients. Side-to-side laxity differences < or = 3 mm were achieved in 80% of autograft patients versus 70% of allograft patients. Single-leg hop scores > or = 90% of the nonoperated leg were obtained in 76% of autograft patients versus 81% of allograft patients. Isokinetic results between groups were also similar. Traumatic ruptures were sustained by four allograft patients at an average of 11 months postoperatively compared with no traumatic ruptures in the autograft group (P = .011). This was the only difference of statistical significance.
The Journal of Bone and Joint Surgery (American), 2009
Anterior cruciate ligament (ACL) reconstruction is a common surgical knee procedure that requires intensive postoperative rehabilitation by the patient. A variety of randomized controlled trials have investigated aspects of ACL reconstruction rehabilitation. A systematic review of English language level 1 and 2 studies identified 54 appropriate randomized controlled trials of ACL rehabilitation. This part of the article discusses open versus closed kinetic chain exercises, neuromuscular electrical stimulation, accelerated rehabilitation, and miscellaneous topics. [J Knee Surg. 2008;21:225-234.]
Anterior cruciate ligament reconstruction: Allograft versus autograft
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2003
This study was performed to compare the minimal 2-year outcome of anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) allografts versus autografts, both augmented with an iliotibial band tenodesis. Type of Study: Retrospective review. Methods: Forty-six of 52 BPTB ACL reconstructions using allografts and 33 of 37 BPTB ACL reconstructions using autografts were followed up at a mean of 2.75 and 3.36 years, respectively. All patients had an iliotibial band tenodesis. Evaluations included the Lysholm II scale, a questionnaire, physical examination findings, and KT-1000 arthrometry. Results: No statistically significant differences were seen between groups in Lysholm II scores or in any subjective category. Most patients (91% allograft; 97% autograft) had good to excellent Lysholm II scores. Sixty-five percent of allograft patients and 73% of autograft patients returned to their preinjury activity level. More allograft patients complained of retropatellar pain (16% v 9% for autograft patients). Fifty-three percent of allograft patients versus 23% of autograft patients had a flexion deficit of 5°or more when compared with the normal contralateral side. When comparing KT-1000 side-to-side differences, we found no significant differences between groups. Ninety-one percent of both groups had maximum side-to-side differences less than 5 mm. Three allograft patients (6.5%) had traumatic ruptures at 12, 19, and 43 months postoperatively versus none in the autograft group. All three allograft patients who sustained postoperative traumatic ruptures had received fresh frozen, nonirradiated allografts. Conclusions: Results of ACL reconstruction using allografts or autografts augmented with an iliotibial band tenodesis were comparable. The BPTB autograft should remain the gold standard, although the BPTB allograft in ACL reconstruction is a reasonable alternative.
The American Journal of Sports Medicine, 2007
Anterior cruciate ligament (ACL) reconstructive surgery is a common elective orthopaedic procedure. In the United States, over 102 000 ACL reconstructions were performed in 1996. Despite the frequency of ACL reconstructions performed, there remain significant discrepancies in surgeon preference regarding ligament graft choice. Common sources include bone-patellar tendon-bone (PT) autografts, 4-strand semitendinosus and gracilis hamstring (HT) autografts, quadriceps tendon autografts with or without bone plug, and allografts from a variety of sources. The differences of opinion regarding graft sources indicate the lack of prospective, long-term studies comparing outcomes of different grafts. In this study, we have prospectively compared the long-term (10-year) outcomes of the 2 most commonly used autograft sources-PT autografts and HT autografts.
Orthopaedic Journal of Sports Medicine, 2019
Background: An individualized approach to anterior cruciate ligament reconstruction (ACLR) typically includes criteria-based postoperative rehabilitation. However, recent literature has suggested residual quadriceps weakness up to 12 months after ACLR, especially with a quadriceps tendon (QT) autograft. Hypothesis: The QT would have poorer quadriceps strength symmetry at 5 to 8 months compared with the hamstring tendon (HS) and patellar tendon (BPTB), but there would be no significant difference at 9 to 15 months among all 3 groups. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent anatomic primary ACLR with an autograft were reviewed retrospectively. Isometric quadriceps and hamstring strength measurements were obtained clinically at 5 to 8 months and 9 to 15 months postoperatively. Return-to-running and return-to-play criteria included greater than 80% and 90% quadriceps strength symmetry, respectively. Results: A total of 73 patients with 5- to 8-m...
Archives of Orthopaedic and Trauma Surgery, 2012
Introduction The most common failure reasons of an anterior cruciate ligament (ACL) graft are incorrect positioning of the drill channels and insuYcient Wxation. In many cases, one-stage revision with patellar tendon graft and the appropriate corrections are possible. For previous use of the ipsilateral patellar tendon third, an allograft seems favorable for reconstruction. So far, no study compared the results of revision surgery of autologous versus allogenous patellar tendon grafts for revision surgery of the ACL in a 5-year follow-up. Materials and methods A retrospective study was conducted to analyze the clinical outcome and stability results 2 years (19.2 § 5.8 months) and 5 years (68.8 § 6.8 months) after revision of ACL reconstruction using middle-third patellar tendon allografts and autografts. The allografts were cleansed by mechanical means only. There were 15 patients in the allograft group and 14 in the autograft group. Patients with isolated re-rupture of the ACL graft were included in the study. Clinical results were evaluated by International Knee Documentation Committee 2000 forms (IKDC), Lysholm score, Tegner activity score, and visual analog scale. Stability was evaluated by means of KT-1000 arthrometer, Lachman test, and pivot-shift test. Location of drill holes was evaluated radiologically. Gonarthritis was graded according to Kellgren and Lawrence on the basis of radiographs. Results There were no signiWcant diVerences between the two groups in anterior translation, manual examination for stability, IKDC 2000 Wndings, Tegner activity score, or Lysholm score. Extension deWcits were more frequent in the autograft group at the Wrst follow-up (P = 0.010). Lateral gonarthritis and femoral tunnel widening were more common in the allograft group at the second follow-up (P = 0.049 and P = 0.023, respectively). Pain on walking downhill was signiWcantly more frequent in the allograft group at the second follow-up (P = 0.027). Conclusions The functional results with allografts that had not undergone irradiation or chemical sterilization were comparable to those with autografts in ACL revision surgery. Allografts represent a good alternative to autogenous patellar tendons in revision surgery.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2012
To compare the results and outcome of anterior cruciate ligament (ACL) reconstruction using autogenous hamstring tendon versus fresh-frozen allograft anterior tibialis tendon. Methods: A prospective randomized study was conducted from September 2002 to October 2006. We randomized 147 patients to undergo ACL reconstruction with either autogenous hamstring or fresh-frozen allograft anterior tibialis tendon. Of these patients, 102 (69%) completed a minimum of 2 years' follow-up. There were 54 patients in the hamstring group (73% of those originally enrolled in the group) and 48 patients in the allograft group (66%). All patients underwent standardized subjective and objective evaluation with functional outcome assessments (International Knee Documentation Committee [IKDC]), and standardized radiographs were also obtained. Results: The mean age was 32.0 years for the autograft group and 33.3 years for the allograft group. There was no difference in stability between the 2 groups (P Ͼ .05). The mean IKDC subjective score was 91.0 for the autograft group and 90.9 for the allograft group (P Ͼ .05). The functional IKDC scores for the autograft group were normal in 46 patients (85%), nearly normal in 7 patients (13%), and severely abnormal in 1 patient. For the allograft group, the functional IKDC scores were normal in 43 patients (90%) and nearly normal in 5 (10%) (P Ͼ .05). There were 4 reoperations in the allograft group and 3 reoperations in the autograft group. No patient underwent revision ACL surgery or planned to undergo revision surgery because of instability in either group during the study period despite the 1 patient in the autograft group with a pivot shift and a maximum manual KT measurement (MEDmetric, San Diego, CA) of 5 mm. Conclusions: The use of fresh-frozen anterior tibialis allograft (non-treated) for ACL reconstruction produced similar subjective and functional outcomes at 24 months' minimal follow-up compared with patients undergoing ACL reconstruction with autograft hamstring tendon. Level of Evidence: Level II, prospective comparative study.