Anterior Cruciate Ligament Reconstruction Using Achilles Tendon Allograft: an Assessment of Outcome for Patients Age 30 Years and Older


Achilles allografts have become popular for anterior cruciate ligament (ACL) reconstructions in older patients. Primary ACL reconstructions using Achilles tendon allografts in patients age 30 years and older are successful in restoring the knee to “normal” or “near normal.” During a three-year period, the two senior authors performed 65 primary ACL reconstructions using Achilles tendon allografts in patients aged 30 years and older. Our exclusion criteria were periarticular fracture, ipsilateral/contralateral knee ligament injury, and previous or concomitant osteotomy or cartilage restoration procedure. Each patient was evaluated via physical examination, functional and arthrometric testing, and radiographic and subjective outcome. Knees were considered normal, near normal, or abnormal based on the International Knee Documentation Committee (IKDC) system. Forty-three patients were examined at an average of 33 months (minimum, 24 months) postoperatively. At the time of ACL reconstruction, 35% had normal articular cartilage in all three compartments and 70% had meniscal tears. No re-ruptures occurred. While 24% had mean maximal translation differences less than or equal to 3 mm, none had side-to-side differences greater than 5 mm. Postoperative IKDC, Activities of Daily Living, and Activity Rating Scale scores averaged 88, 94, and 7.7, respectively. Despite the overall favorable outcomes, 29% had worsened radiographic grades at follow-up. Using an Achilles allograft for ACL reconstruction in patients older than 30 years, we restored over 90% of knees to normal or near normal while limiting postoperative complications. Poor subjective results may be related less to instability and more to pain, which may result from progressive arthritis.

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Corresponding author

Correspondence to Robert A. Gallo MD.

Additional information

This study was supported by outside funding or grant(s) from the Institute for Sports Medicine Research, New York, NY.

None of the researchers or an affiliated institute has received (or agreed to receive) from a commercial entity something of value (exceeding the equivalent of US $500) related in any way to this manuscript or research.

Each author certifies that his or her institution has approved the reporting of these cases, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participating in the study was obtained.

Research was performed at the Hospital for Special Surgery, New York, NY.

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Chehab, E.L., Flik, K.R., Vidal, A.F. et al. Anterior Cruciate Ligament Reconstruction Using Achilles Tendon Allograft: an Assessment of Outcome for Patients Age 30 Years and Older. HSS Jrnl 7, 44–51 (2011).

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  • anterior cruciate ligament reconstruction
  • allograft