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Prospective Comparison of Auto and Allograft Hamstring Tendon Constructs for ACL Reconstruction

  • Original Article
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Clinical Orthopaedics and Related Research

Abstract

Although allograft use for primary anterior cruciate ligament reconstruction has continued to increase during the last 10 years, concerns remain regarding the long-term function of allografts (primarily that they may stretch with time) and clinical efficacy compared with autograft tendons. We attempted to address these issues by prospectively comparing identical quadrupled hamstring autografts with allograft constructs for primary anterior cruciate ligament reconstruction in patients with a minimum followup of 3 years. Eighty-four patients (37 with autografts and 47 with allografts) were enrolled; the mean followup was 52 ± 11 months for the autograft group and 48 ± 8 months for the allograft group. Outcome measurements included objective and subjective International Knee Documentation Committee scores, Lysholm scores, Tegner activity scales, and KT-1000 arthrometer measurements. The two cohorts were similar in average age, acute or chronic nature of the anterior cruciate ligament rupture, and incidence of concomitant meniscal surgeries. At final followup, we found no difference in terms of Tegner, Lysholm, KT-1000, or International Knee Documentation Committee scores. Five anterior cruciate ligament reconstructions failed: three in the autograft group and two in the allograft group. Our data suggest laxity is not increased in allograft tendons compared with autografts and clinical outcome scores 3 to 6 years after surgery are similar.

Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Andrew J. Haas MD and Joshua Hornstein MD, previous sports medicine fellows of AAS, for help with data collection and continued guidance. Limitations on author length preclude their inclusion as authors of this paper, but their efforts and dedication are greatly appreciated.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Boston University Medical Center, Doctors Office Building, Suite 808, 720 Harrison Avenue, Boston, MA, 02118, USA

    Cory M. Edgar MD, PhD, Scott Zimmer BS, Sanjeev Kakar MD, MRCS, Hugh Jones MD & Anthony A. Schepsis MD

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  1. Cory M. Edgar MD, PhD
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  2. Scott Zimmer BS
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  3. Sanjeev Kakar MD, MRCS
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  4. Hugh Jones MD
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  5. Anthony A. Schepsis MD
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Correspondence to Anthony A. Schepsis MD.

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Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patient/licensing arrangements, etc) that might pose a conflict of interest in connection with the collection of this data and the submitted article.

Each author certifies that his institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained.

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Edgar, C.M., Zimmer, S., Kakar, S. et al. Prospective Comparison of Auto and Allograft Hamstring Tendon Constructs for ACL Reconstruction. Clin Orthop Relat Res 466, 2238–2246 (2008). https://doi.org/10.1007/s11999-008-0305-5

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  • DOI: https://doi.org/10.1007/s11999-008-0305-5

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