Skip to main content

Advertisement

SpringerLink
Log in

Anterior cruciate ligament reconstruction with fresh-frozen patellar tendon allografts: sixty cases with 2 years' minimum follow-up

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

A prospective study was performed on 101 patients who underwent an arthroscopic anterior cruciate ligament (ACL) reconstruction with fresh-frozen patellar tendon allograft (bone-patellar tendon-bone). We present the results of the first 60 patients with a minimum follow-up of 2 years. Thirty four were men and 26 women with a mean age of 23. In 45 patients, a postoperative arthroscopy was performed, and tissue biopsies of the reconstructed ACL were obtained. Patients were evaluated according to the International Knee Documentation Committee evaluation form. After a mean follow-up of 47 months, the overall results were normal or nearly normal in 85%. Under postoperative arthroscopy, the macroscopic appearance of the implant was similar to that of a normal ligament. The ACL allograft was covered with a normal. well-vascularized synovium. There were no cases of infection, disease transmission or tissue rejection. We conclude that the use of fresh-frozen patellar tendon allografts is a good method of ACL reconstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Association of Tissue Banks (1987) Standards for bone banking. American Association of Tissue Banks, McLean, Virginia

    Google Scholar 

  2. Amiel D, Kleiner JB, Roux RD, Harwood FL, Akeson WH (1986) The phenomenon of ligamentization: anterior cruciate ligament reconstruction with autogenous patellar tendon. J Orthop Res 4:162–172

    Google Scholar 

  3. Bance de huesos del sistema musculoesquelético: aplicaciones clínicas. Rev Med Univ Nav 34:227–234

  4. Arnoczky S, Warren P, Ashlock M (1986) Replacement of the anterior cruciate ligament using a patellar tendon allograft. J Bone Joint Surg [Am] 68:376–385

    Google Scholar 

  5. Buck BE, Malinin TL, Brown MD (1989) Bone transplantation and human immunodeficiency virus: an estimate of risk of acquired immunodeficiency syndrome (AIDS). Clin Orthop 251:249–253

    Google Scholar 

  6. Butler D (1991) Irradiation of 2 Mrad or less is safe for sterilizing allograft ligaments; but 3 Mrad irradiation weaken tissues. Am J Sports Med 19: 7–11

    Google Scholar 

  7. Conway B, Tomford WW, Hirsch MS (1990) Effects of gamma irradiation on HIV-1 in a bone allograft model. Trans. Orthop Res Soc 15:225–230

    Google Scholar 

  8. Curtis R, De Lee J, Drez D (1985) Reconstruction of the anterior cruciate ligament with freeze dried fascia lata allografts in dogs: a preliminary report. Am J Sports Med 13:408–414

    Google Scholar 

  9. Drez D, De Lee J, Holden J, Arnoezky S, Noyes F, Roberts T (1991) Amerior cruciate ligament reconstruction using bone-patellar tendon-bone allografts: a biological and biomechanical evaluation in goats. Am J Sports Med 19: 256–263

    Google Scholar 

  10. Fahey M, Indelicato PA (1994) Bone tunnel enlargement after anterior cruciate ligament replacement. Am J Sports Med 22:410–414

    Google Scholar 

  11. Fideler BM, Vangsness CT Jr, West HS Jr, Moore T, Li Z, Rasheed S (1994) Effects of gamma irradiation on the human immunodeficiency virus. A study in frozen human bone-patellar ligament-bone grafts obtained from infected cadavera. J Bone Joint Surg [Am] 76:1032–1035

    Google Scholar 

  12. Gibbons MJ, Butler DL, Grood ES, Bylski-Austrow DI, Levy MS, Noyer FR (1991) Effects of gamma irradiation on the initial mechanical and material properties of goat bone-patellar tendon-bone allografts. J Orthop Res 9:209–218

    Google Scholar 

  13. Harner CD, Irrgang JJ, Paul J, Dearwater S, Fu F (1992) Loss of motion after anterior cruciate ligament reconstruction. Am J Sports Med 20:499–506

    Google Scholar 

  14. Harner CD, Marks PH, Fu FH, Irrgang JJ, Silby MB, Mengato R (1994) Anterior cruciate ligament reconstruction: endoscopic versus two-incision technique. Arthroscopy 10:502–512

    Google Scholar 

  15. Harner CD, Olson E, Irrgang JJ, Silverstein S, Fu FH, Silbey M (1996) Allograft versus autograft anterior cruciate ligament reconstruction: 3-to-5 year outcome. Clin Orthop 324:134–144

    Google Scholar 

  16. Hefti F, Mueller W, Jacob RP, Staubli HU (1993) Evaluation of knee-ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrose 1:226–234

    Google Scholar 

  17. Indelicato P, Bittar E, Prevot T, Woods G, Branch T, Huegel M (1990) Clinical comparison of freeze-dried and fresh frozen patellar tendon allografts for ACL reconstruction of the knee. Am J Sports Med 18:335–342

    Google Scholar 

  18. Indelicato PA, Linton RC, Hueggel M (1992) The results of fresh frozen patellar tendon allografts for chronic anterior cruciate ligament deficiency of the knee. Am J Sports Med 18:335–342

    Google Scholar 

  19. Jackson DW, Windler G, Simon T (1990) Intraarticular reaction associated with the use of freeze dried, ethylene oxide-sterilized bone-patellar tendon-bone allografts in the reconstruction of the anterior cruciate ligament. Am J Sports Med 18:1–10

    Google Scholar 

  20. Jackson DW, Rosen M, Simon TM (1992) Soft tissue allograft reconstruction: the knee. In: Czitrom AA, Gross AE (eds.) Allografts in orthopaedic practice. Williams and Wilkins, Baltimore, pp 197–216

    Google Scholar 

  21. Jackson DW, Corsetti J, Simon TM (1996) Biologic incorporation of allograft cruciate replacements. Clin Orthop 324:126–133

    Google Scholar 

  22. Jonsson T, Althoff B, Peterson L, Renstrom P (1982) Clinical diagnosis of ruptures of the anterior drawer sign. Am J Sports Med 10:100–102

    Google Scholar 

  23. Kannus P, Jarvinen M (1987) Conservatively treated tears of the anterior cruciate ligament: long term results. J Bone Joint Surg [Am] 67:1007–1012

    Google Scholar 

  24. Kleipool A, Van Loon T, Marti R (1994) Pain after use of the central third of the patellar tendon for cruciate ligament reconstruction. Acta Orthop Scand 65:62–66

    Google Scholar 

  25. Lutz GE, Palmitier RA, An KN, Chao EYS (1993) Comparison of tibiofemoral joint forces during open-kinetic-chain and closed-kinetic-chain exercises. J Bone Joint Surg [Am] 75:732–739

    Google Scholar 

  26. McDaniel WR, Dameron TB Jr (1980) Untreated ruptures of the anterior cruciate ligament: a follow up study. J Bone Joint Surg [Am] 62:696–705

    Google Scholar 

  27. Natri A, Jarvinen M, Lehto M, Kannus P (1996) Reconstruction of the chronically insufficient anterior cruciate ligament. Long term results of the Eriksson procedure. Int Orthop 20:28–31

    Google Scholar 

  28. Nikolau PK, Seaber AV, Gilsson RR, Ribbeck BM, Bassett FH (1986) Anterior cruciate ligament allograft transplantation: long term function, histology, revascularization and operative technique. Am J Sports Med 14:328–360

    Google Scholar 

  29. Noyes F, Barber S (1996) Revision anterior cruciate ligament surgery: experience from Cincinnati. Clin Orthop 325:116–129

    Google Scholar 

  30. Noyes F, Barber S (1996) Reconstruction of the anterior cruciate ligament with human allograft. Comparison of early and later results. J Bone Joint Surg [Am] 74:524–537

    Google Scholar 

  31. Noyes F, Barber S, Mangine R (1990) Bone-patellar-bone and fascia lata allografts for reconstruction of the anterior cruciate ligament. J Bone Joint Surg [Am] 72:1125–1136

    Google Scholar 

  32. Olson EJ (1993) Use of soft tissue allografts in sports medicine. Adv Oper Orthop 1:111–128

    Google Scholar 

  33. Paulos LE, France EP, Rosemberg TD (1987) Comparative material properties of allograft tissues for ligament replacement. Effect of type, age, sterilization, and preservation. Trans Orthop Res Soc 12:129–135

    Google Scholar 

  34. Pelker RP, Friedlander GE, Markham TC (1983) Biomechanical properties of bone allografts. Clin Orthop 174:54–57

    Google Scholar 

  35. Rasmussen TJ, Feder SM, Butler DL, Noyes FR (1994) The effects of 4 MRad of gamma irradiation on the initial mechanical properties of bonepatellar tendon-bone grafts. Arthroscopy 10:188–197

    Google Scholar 

  36. Roberts TS, Drez D, McCarthy W (1991) Anterior cruciate ligament reconstruction using freeze-dried, ethylene-oxide-sterilized bone-patellar tendon-bone allografts. Two year results in 36 patients. Am J Sports Med 19: 35–41

    Google Scholar 

  37. Ruwe PA, Shields CL (1995) Allograft ACL reconstruction. Orthop Int 3: 207–211

    Google Scholar 

  38. Sachs RA, Daniel DM, Stone ML, Garfein RF (1989) Patellofemoral problems after anterior eruciate ligament reconstruction. Am J Sports Med 17:760–765

    Google Scholar 

  39. Sala D (1992) Reconstrucción del ligamento cruzado anterior de la rodilla con tendón rotuliano autólogo y homólogo crioconservado en fresco Estudio experimental en ovejas. Doctoral thesis. University of Navarra, Pamplona, Spain

    Google Scholar 

  40. Sanchis V, Gomar F (1993) Sustitución del ligamento cruzado anterior mediante aloinjertos tendinosos crioconservados Comportamiento biológico del implante a nivel intraarticular. Estudio experimental. Rev Ortop Traum 37 (IB):87–97

    Google Scholar 

  41. Shino K, Kawasaki T, Hirose H, Gotoh I, Inuoe M, Ono K (1984) Replacement of anterior cruciate ligament by an allogenic tendon graft: a experimental study in the dog. J Bone Joint Surg [Br] 66:672–681

    Google Scholar 

  42. Shino K, Inoue M, Horibe S, Nagano J, Ono K (1988) Maturation of allograft tendons transplanted into the knee. J Bone Joint Surg [Br] 70:556–560

    Google Scholar 

  43. Shino K, Inoue M, Nakamura H (1989) Arthroscopic follow-up of the anterior cruciate ligament reconstruction using allogeneic tendon. Arthroscopy 5: 165–171

    Google Scholar 

  44. Shino K, Nakata K, Inuoe M, Horibe S, Hamada M, Nakamura N, Toritsuka Y (1992) Quantiative evaluation following arthroscopic ACL reconstruction: autograft vs allograft. Abstract of the First World Congress of Sports Trauma, Spain

  45. Shino K, Nakagava S, Inoue M, Horibe S, Yoneda M (1993) Deterioration of patellofemoral articular surfaces after anterior cruciate ligament reconstruction. Am J Sports Med 21:206–211

    Google Scholar 

  46. Thorson E, Rodrigo J, Vasseur P, Sharkey N, Heitter D (1987) Comparison of frozen allograft versus fresh autologous anterior cruciate ligament replacement in the dog. Trans. Orthop Res Soc 12:65–70

    Google Scholar 

  47. Thorson E, Rodrigo J, Vasseur P, Sharkey N, Heitter D (1989) Replacement of ACL: a comparison of autografts and allografts in dogs. Acta Orthop Scand 60:555–560

    Google Scholar 

  48. Uribe JW, Hechtman KS, Kvijac JE, Tjin-A-Tsoi EW (1996) Revision anterior cruciate ligament surgery: experience from Miami. Clin Orthop 325: 91–99

    Google Scholar 

  49. Vasseur PB, Rodrigo UJ, Stevenson S, Clark G, Shonkey N (1987) Replacement of the anterior cruciate ligament with a bone-ligament-bone anterior cruciate ligament allograft in dogs. Clin Orthop 219:268–277

    Google Scholar 

  50. Woo SL, Hollis JM, Adams DS (1991) The tensile properties of human femuranterior cruciate ligament-tibia complex. Am J Sports Med 19:217–225

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, University Clinic of Navarra, Av. Pío 12n. 36, E-31008, Pamplona, Spain

    J. R. Valentí Nín, M. Leyes & D. Schweitzer

Authors
  1. J. R. Valentí Nín
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Leyes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Schweitzer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Valentí Nín, J.R., Leyes, M. & Schweitzer, D. Anterior cruciate ligament reconstruction with fresh-frozen patellar tendon allografts: sixty cases with 2 years' minimum follow-up. Knee Surg, Sports traumatol, Arthroscopy 4, 137–142 (1996). https://doi.org/10.1007/BF01577405

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01577405

Key words

Search

Navigation