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Revision of anterior cruciate ligament reconstruction with allografts in patients younger than 40 years old: a 2 to 4 year results

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

Abstract

Purpose

The purpose of this study is first to report the outcomes, at 4 years follow-up, in revision ACL surgery using allografts in patients younger than 40 years old, and then compared soft tissue allografts to bone tendon allografts.

Methods

This retrospective study included 47 patients who underwent ACL revision surgery with fresh-frozen allografts. Patellar tendon allograft or tibialis anterior allograft was used. Twenty-seven patients undergoing ACL revision with patellar tendon allograft were compared retrospectively with twenty-two patients undergoing the same procedure with soft tissue tibialis anterior allograft. Lysholm, IKDC, and KT-1000 values were obtained preoperatively and postoperatively.

Results

The average patient follow-up was 4.6 years (±2.5). The mean age at time of the revision was 34 years old (±6.3). Overall, patients reported the overall condition of their knee as excellent or good in 85 % of the patients (10 excellent, 33 good). Based on their experience, 85 % would have the surgery again if they had the same problem in the other knee. Both subgroups experienced significant improvement in Lysholm, IKDC, and KT-1000 values, with no difference found between groups at final follow-up.

Conclusion

Revision ACL with allografts has excellent and good results in 85 % of patients younger than 40 years old. No statistical difference was seen between soft tissue (tibialis anterior) and patellar tendon allograft.

Level of evidence

IV.

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References

  1. Aglietti P, Giron F, Buzzi R, Biddau F, Sasso F (2004) Anterior cruciate ligament reconstruction: bone-patellar tendon-bone compared with double semitendinosus and gracilis tendon grafts. A prospective, randomized clinical trial. J Bone Joint Surg Am 10:2143–2155

    Google Scholar 

  2. Gr Barrett, Luber K, Replogle Wh, Manley JL (2010) Allograft anterior cruciate ligament reconstruction in the young, active patient: tegner activity level and failure rate. Arthroscopy 12:1593–1601

    Google Scholar 

  3. Bedi A, Musahl V, Steuber V, Kendoff D, Choi D, Allen AA, Pearle AD, Altchek DW (2011) Transtibial versus anteromedial portal reaming in anterior cruciate ligament reconstruction: an anatomic and biomechanical evaluation of surgical technique. Arthroscopy 3:380–390

    Article  Google Scholar 

  4. Bhatia S, Bell R, Frank RM, Rodeo SA, Bach BR, Cole BJ Jr, Chubinskaya S, Wang VM, Verma NN (2012) Bony incorporation of soft tissue anterior cruciate ligament grafts in an animal model: autograft versus allograft with low-dose gamma irradiation. Am J Sports Med 40:1789–1798

    Article  PubMed  Google Scholar 

  5. Borchers JR, Pedroza A, Kaeding C (2009) Activity level and graft type as risk factors for anterior cruciate ligament graft failure: a case-control study. Am J Sports Med 12:2362–2367

    Article  Google Scholar 

  6. Ellis HB, Matheny LM, Briggs KK, Pennock AT, Steadman JR (2012) Outcomes and revision rate after bone-patellar tendon-bone allograft versus autograft anterior cruciate ligament reconstruction in patients aged 18 years or younger with closed physes. Arthroscopy 12:1819–1825

    Article  Google Scholar 

  7. Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2:175–191

    Article  Google Scholar 

  8. Gorschewsky O, Klakow A, Riechert K, Pitzl M, Becker R (2005) Clinical comparison of the tutoplast allograft and autologous patellar tendon (bone-patellar tendon-bone) for the reconstruction of the anterior cruciate ligament: 2- and 6-year Results. Am J Sports Med 8:1202–1209

    Article  Google Scholar 

  9. Jackson DW, Grood ES, Goldstein JD, Rosen MA, Kurzweil PR, Cummings JF, Simon TM (1993) A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model. Am J Sports Med 2:176–185

    Article  Google Scholar 

  10. Kaminski A, Gut G, Marowska J, Lada-Kozlowska M, Biwejnis W, Zasacka M (2009) Mechanical properties of radiation-sterilised human bone-tendon-bone grafts preserved by different methods. Cell Tissue Bank 3:215–219

    Article  Google Scholar 

  11. Lawhorn KW, Howell SM, Traina SM, Gottlieb JE, Meade TD, Freedberg HI (2012) The effect of graft tissue on anterior cruciate ligament outcomes: a multicenter, prospective, randomized controlled trial comparing autograft hamstrings with fresh-frozen anterior tibialis allograft. Arthroscopy 8:1079–1086

    Article  Google Scholar 

  12. Lind M, Menhert F, Pedersen AB (2012) Incidence and outcome after revision anterior cruciate ligament reconstruction: results from the Danish registry for knee ligament reconstructions. Am J Sports Med 7:1551–1557

    Article  Google Scholar 

  13. Mars Group, Wright RW, Huston LJ, Spindler KP, Dunn WR, Haas AK, Allen CR, Cooper DE, Deberardino TM, Lantz BB, Mann BJ, Stuart MJ (2010) Descriptive epidemiology of the multicenter ACL revision study (Mars) Cohort. Am J Sports Med 10:1979–1986

  14. Nikolaou PK, Seaber AV, Glisson RR, Ribbeck BM, Bassett FH 3rd (1986) Anterior cruciate ligament allograft transplantation long-term function, histology, revascularization, and operative technique. Am J Sports Med 5:348–360

    Article  Google Scholar 

  15. Noyes FR, Barber-Westin SD (2006) Revision anterior cruciate ligament reconstruction using a 2-stage technique with bone grafting of the tibial tunnel. Am J Sports Med 4:678–679

    Article  Google Scholar 

  16. Pallis M, Svoboda SJ, Cameron KL, Owens BD (2012) Survival comparison of allograft and autograft anterior cruciate ligament reconstruction at the united states military academy. Am J Sports Med 6:1242–1246

    Article  Google Scholar 

  17. Rihn JA, Irrgang JJ, Chhabra A, Fu Fh, Harner CD (2006) Does irradiation affect the clinical outcome of patellar tendon allograft ACL reconstruction? Knee Surg Sports Traumatol Arthrosc 9:885–896

    Article  Google Scholar 

  18. Rodeo SA, Arnoczky SP, Torzilli PA, Hidaka C, Warren RF (1993) Tendon-healing in a bone tunnel a biomechanical and histological study in the dog. J Bone Joint Surg Am 12:1795–1803

    Google Scholar 

  19. Salmon LJ, Pinczewski LA, Russell VJ, Refshauge K (2006) Revision anterior cruciate ligament reconstruction with hamstring tendon autograft: 5- to 9-year follow-up. Am J Sports Med 10:1604–1614

    Article  Google Scholar 

  20. Sherman Oh, Banffy MB (2004) Anterior cruciate ligament reconstruction: which graft is best? Arthroscopy 9:974–980

    Article  Google Scholar 

  21. Singhal MC, Gardiner JR, Johnson DL (2007) Failure of primary anterior cruciate ligament surgery using anterior tibialis allograft. Arthroscopy 5:469–475

    Article  Google Scholar 

  22. Sun K, Zhang J, Wang Y, Xia C, Zhang C, Yu T, Tian S (2011) Arthroscopic reconstruction of the anterior cruciate ligament with hamstring tendon autograft and fresh-frozen allograft: a prospective, randomized controlled study. Am J Sports Med 7:1430–1438

    Article  Google Scholar 

  23. Trojani C, Sbihi A, Djian P, Potel JF, Hulet C, Jouve F, Bussiere C, Ehkirch FP, Burdin G, Dubrana F, Beaufils P, Franceschi JP, Chassaing V, Colombet P, Neyret P (2011) Causes for failure of ACL reconstruction and influence of meniscectomies after revision. Knee Surg Sports Traumatol Arthrosc 2:196–201

    Article  Google Scholar 

  24. Wright RW, Dunn WR, Amendola A, Andrish JT, Flanigan DC, Jones M, Kaeding CC, Marx RG, Matava MJ, Mccarty EC, Parker RD, Vidal A, Wolcott M, Wolf BR, Spindler KP, Moon Cohort (2007) Anterior cruciate ligament revision reconstruction: two-year results from the moon cohort. J Knee Surg 4:308–311

    Google Scholar 

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Correspondence to Cecilia Pascual-Garrido.

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Pascual-Garrido, C., Carbo, L. & Makino, A. Revision of anterior cruciate ligament reconstruction with allografts in patients younger than 40 years old: a 2 to 4 year results. Knee Surg Sports Traumatol Arthrosc 22, 1106–1111 (2014). https://doi.org/10.1007/s00167-013-2507-y

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