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Superior return to sports rate after patellar tendon autograft over patellar tendon allograft in revision anterior cruciate ligament reconstruction

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

Abstract

Purpose

After revision anterior cruciate ligament reconstruction (ACLR), the rate of return to the pre-injury type of sport (RTS type) is low and graft choice might be an important factor. The aim of this study was to determine whether there is a difference in outcome after revision ACLR using a patellar tendon allograft compared to an ipsilateral patellar tendon autograft. It was hypothesized that the rate of RTS type using an ipsilateral patellar tendon autograft will be superior to using patellar tendon allograft.

Methods

The design is a retrospective cohort study. Inclusion criteria were patients who underwent revision ACLR with a minimum follow-up of 1 year after revision using a patellar allograft or ipsilateral autograft. Primary study parameter was rate of RTS type. Secondary study parameters were RTS level, subscores of the KOOS, the IKDCsubjective, the Tegner score and reasons for no RTS.

Results

Eighty-two patients participated in this study (36 allografts and 46 autografts). In patients with a minimum follow-up of 1 year, rate of RTS type was 51.4% for the patellar tendon allograft and 62.8% for the patellar tendon autograft group (n.s.). In patients with a minimum follow-up rate of 2 years, rate of RTS type was 43.3 versus 75.0%, respectively (p = 0.027). No differences in secondary study parameters were found. In patients with a minimum follow-up of 1 year, rate of RTS type was significantly higher (p = 0.025) for patients without anxiety compared to patients who were anxious to perform certain movements.

Conclusion

After a minimum follow-up of 2 years, rate of RTS type is in favour of using an ipsilateral patellar tendon autograft when compared to using a patellar tendon allograft in patients undergoing revision ACLR; after a minimum follow-up of 1 year, no significant difference was found. In revision ACLR, the results of this study might influence graft choice in favour of autologous graft when the use of an allograft or autograft patellar tendon is considered.

Level of evidence

III.

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Authors and Affiliations

  1. Center for Human Movement Science, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Michèle N. J. Keizer & Egbert Otten

  2. Centre for Orthopaedic Surgery OCON, Hengelo, The Netherlands

    Roy A. G. Hoogeslag

  3. Department of Orthopaedic Surgery, Martini Hospital Groningen, Van Swietenplein 1, 9728 NT, Groningen, The Netherlands

    Jos J. A. M. van Raay & Reinoud W. Brouwer

Authors
  1. Michèle N. J. Keizer
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  2. Roy A. G. Hoogeslag
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  3. Jos J. A. M. van Raay
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  4. Egbert Otten
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  5. Reinoud W. Brouwer
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Corresponding author

Correspondence to Reinoud W. Brouwer.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

No external source of funding was used.

Ethical approval

The Medical Ethical Committee of Martini Hospital approved the study design, procedures and protocol (METC No. 2014-87).

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For this type of study formal consent is not required.

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Keizer, M.N.J., Hoogeslag, R.A.G., van Raay, J.J.A.M. et al. Superior return to sports rate after patellar tendon autograft over patellar tendon allograft in revision anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 26, 574–581 (2018). https://doi.org/10.1007/s00167-017-4612-9

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  • DOI: https://doi.org/10.1007/s00167-017-4612-9

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