Note: To access the supplementary materials accompanying this article, visit the July 2005 issue of Arthroscopy at www.arthroscopyjournal.org.
Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original articleAnalysis of Outcomes of Anterior Cruciate Ligament Repair With 5-Year Follow-up: Allograft Versus Autograft
Section snippets
Methods
From November 1994 through May 1999, 352 patients underwent unilateral ACL reconstructions; 219 of these patients were eligible to participate in the study. ACL reconstruction surgery was performed by 3 surgeons at 1 institution: 1 surgeon performed arthroscopic reconstruction using allograft and the other 2 performed arthroscopically-assisted reconstruction using BPTB autograft.
Patients were excluded from the study if they had previous injury or surgery on the affected knee, multiple
Results
At the time of surgery, it was determined that 18 of the 219 patients enrolled in the study were ineligible for participation (12 who did not sustain an ACL rupture, 5 who had multiple ligament injuries, and 1 patient who had a nonstandard surgical procedure). A final review of patients revealed an additional 25 patients who were excluded from the study (17 patients with previous knee arthrotomies, 6 patients who were age ineligible, 1 patient with a head injury, and 1 patient who developed a
Discussion
Reconstruction of the injured ACL has been performed using a variety of autograft and allograft ligament substitutes. The use of autologous BPTB has been considered the gold standard and the first choice of many surgeons for a variety of reasons.17, 18 Multiple studies have shown good results using this method.6, 19, 20, 21 Autologous tissue avoids the perceived risk of disease transmission that is associated with allografts. Although the composite risk of harvesting and processing tissues from
Conclusions
Reconstruction of the ACL using either BPTB autograft or freeze-dried Achilles tendon allograft was successful for establishing knee stability that was maintained for up to 5 years. Allograft patients reported fewer role limitations due to physical health problems compared with autograft patients from 6 weeks to 6 months postoperatively, and better overall physical functioning at 1 to 2 weeks, 3 months, and 1 year. Significant differences on the Rand-36 pain subscale, the Knee Pain
Acknowledgment
The authors thank Monte Hunter, M.D., of the Department of Orthopaedic Surgery, Medical College of Georgia; Gloria Hairston, E.M.T.; and Denise Tickle, P.T., for their assistance in carrying out this study.
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