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A prospective randomized comparison of irradiated and non-irradiated hamstring tendon allograft for ACL reconstruction

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

Abstract

Purpose

To analyze the outcome of arthroscopic anterior cruciate ligament reconstruction with irradiated versus non-irradiated hamstring tendon allograft.

Methods

All hamstring tendon allografts were obtained from a single certified tissue bank, and the irradiated allografts were sterilized with 2.5 Mrad of irradiation prior to distribution. A total of 78 patients who met the inclusion and exclusion criteria of the study were prospectively randomized consecutively into two groups (Non-ir-Allo vs. Ir-Allo). All the operations were done by the same senior surgeon. Before surgery and at follow-up, patients were evaluated by the same observer according to clinical evaluations including the Lachman test, ADT, pivot shift test, varus/valgus stress test, the instrumented KT-2000 arthrometer testing, vertical jump test, one-leg hop test, ROM of knee, Cincinnati knee score, IKDC Subjective Knee Form, Tegner activity score, modified Lysholm knee scoring scale, and the standard knee ligament evaluation form of the IKDC.

Results

Of these patients, 69 (Non-ir-Allo 38, Ir-Allo 31) were available for full evaluation. When compared the Ir-Allo group with Non-ir-Allo group at the final follow-up by Lachman test, ADT, pivot shift test, and KT-2000 arthrometer testing, statistically significant differences were found (P < 0.05). Most importantly, 84% of patients in the Non-ir-Auto group and just only 32% in the Ir-Allo group had a side-to-side difference of less than 3 mm according to KT-2000. The anterior and rotational stability decreased significantly in the Ir-Allo group. According to the overall IKDC, functional, subjective evaluations, and activity level testing, no statistically significant differences were found between the two groups (n.s.). As to the osteoarthritis (OA) rate, for the Non-ir-Allo group, there was no significant difference (n.s.) in development of OA between the operated knee and contralateral knee at the final follow-up. While for the Ir-Allo group, significant difference (P < 0.05) was found in development of OA between the operated knee and contralateral knee. There was statistical difference (P < 0.05) between the Non-ir-Allo and Ir-Allo groups when comparing the development of OA of the operated knees at the final follow-up.

Conclusion

There was a significant difference in knee stability between the two groups (in favor of Non-ir-Allo), but no differences in functional scores should be pointed out clearly.

Level of evidence

I.

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Acknowledgments

The study was supported by Natural Science Foundation of Shandong Province (Key Project: Z2008C10) which provided the funding. There was no external funding source.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Joint Surgery, The Affiliated Hospital of Medical College, Qingdao University, No. 16 Jiangsu Road, 266003, Qingdao, Shandong, China

    Kang Sun, Cailong Zhang, Changsuo Xia, Tengbo Yu & Shaoqi Tian

  2. Healthy Physical Examination Center, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China

    Jihua Zhang

  3. Department of Obstetrics and Gynecology, Qingdao Woman and Children’s Hospital, 266003, Qingdao, Shandong, China

    Yan Wang

  4. Department of Orthopaedics, The Affiliated Hospital of Medical College, Qingdao University, No. 16 Jiangsu Road, 266003, Qingdao, Shandong, China

    Kang Sun & Shaoqi Tian

Authors
  1. Kang Sun
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  2. Jihua Zhang
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  3. Yan Wang
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  4. Cailong Zhang
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Correspondence to Kang Sun or Shaoqi Tian.

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Sun, K., Zhang, J., Wang, Y. et al. A prospective randomized comparison of irradiated and non-irradiated hamstring tendon allograft for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 20, 187–194 (2012). https://doi.org/10.1007/s00167-010-1393-9

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  • DOI: https://doi.org/10.1007/s00167-010-1393-9

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