J Knee Surg 2016; 29(04): 322-328
DOI: 10.1055/s-0035-1554923
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Allograft Anterior Cruciate Ligament Reconstruction in Patients Younger than 25 Years

Thomas R. Carter
1   The Orthopedic Clinic Association, TOCA, Phoenix, Arizona
,
Michael T. Rabago
1   The Orthopedic Clinic Association, TOCA, Phoenix, Arizona
› Author Affiliations
Further Information

Publication History

19 February 2015

31 March 2015

Publication Date:
30 July 2015 (online)

Abstract

Purpose The purpose of this study was to evaluate the outcomes for patients younger than 25 years who had anterior cruciate ligament (ACL) reconstructions with allograft tissue.

Methods A total of 52 ACL reconstructions performed with fresh-frozen, nonirradiated tibialis or Achilles allografts in active patients younger than 25 years. Outcome evaluations included the International Knee Documentation Committee (IKDC) objective and subjective forms, KT-1000 arthrometry and Lysholm.

Results Forty-two patients were available for follow-up at an average follow-up of 65 months (range, 33–99 months). The average age at surgery was 17 years and 7 months (range, 11 years 10 months–24 years 8 months). Objective and subjective data were obtained from 37 patients with 1 requiring revision, and 5 patients had only subjective data. IKDC objective results were 29-A and 5-B. KT-1000 differences were 0 mm for 4 patients, 1 mm for 23, 2 mm for 8, 3 mm for 1, and > 5 mm for 1 patient. The average IKDC subjective score was 90.2 ± 15.0 and average Lysholm score was 90.0 ± 11.

Conclusion The result of our study found that using nonirradiated Achilles or tibialis tendon allografts for ACL reconstructions in active patients younger than 25 years can achieve good outcomes, with a low rate of failure.

 
  • References

  • 1 Sun K, Tian S, Zhang J, Xia C, Zhang C, Yu T. Anterior cruciate ligament reconstruction with BPTB autograft, irradiated versus non-irradiated allograft: a prospective randomized clinical study. Knee Surg Sports Traumatol Arthrosc 2009; 17 (5) 464-474
  • 2 Krych AJ, Jackson JD, Hoskin TL, Dahm DL. A meta-analysis of patellar tendon autograft versus patellar tendon allograft in anterior cruciate ligament reconstruction. Arthroscopy 2008; 24 (3) 292-298
  • 3 Rappé M, Horodyski M, Meister K, Indelicato PA. Nonirradiated versus irradiated Achilles allograft: in vivo failure comparison. Am J Sports Med 2007; 35 (10) 1653-1658
  • 4 Park SS, Dwyer T, Congiusta F, Whelan DB, Theodoropoulos J. Analysis of irradiation on the clinical effectiveness of allogenic tissue when used for primary anterior cruciate ligament reconstruction. Am J Sports Med 2015; 43 (1) 226-235
  • 5 Ellis HB, Matheny LM, Briggs KK, Pennock AT, Steadman JR. 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 2012; 28 (12) 1819-1825
  • 6 Stuart K, Getelman MH. ACL reconstruction in patients under age 25: outcome and failure rates of autograft and allograft. Arthroscopy 2013; 29: e6 (88–11)
  • 7 Shah AA, McCulloch PC, Lowe WR. Failure rate of Achilles tendon allograft in primary anterior cruciate ligament reconstruction. Arthroscopy 2010; 26 (5) 667-674
  • 8 Hettrich CM, Dunn WR, Reinke EK, Spindler KP ; MOON Group. The rate of subsequent surgery and predictors after anterior cruciate ligament reconstruction: two- and 6-year follow-up results from a multicenter cohort. Am J Sports Med 2013; 41 (7) 1534-1540
  • 9 Kaeding CC, Aros B, Pedroza A , et al. Allograft versus autograft anterior cruciate ligament reconstruction: predictors of failure from a MOON prospective longitudinal cohort. Sports Health 2011; 3 (1) 73-81
  • 10 Fuchs R, Wheatley W, Uribe JW, Hechtman KS, Zvijac JE, Schurhoff MR. Intra-articular anterior cruciate ligament reconstruction using patellar tendon allograft in the skeletally immature patient. Arthroscopy 2002; 18 (8) 824-828
  • 11 Barrett GR, Luber K, Replogle WH, Manley JL. Allograft anterior cruciate ligament reconstruction in the young, active patient: Tegner activity level and failure rate. Arthroscopy 2010; 26 (12) 1593-1601
  • 12 Barber FA, Aziz-Jacobo J, Oro FB. Anterior cruciate ligament reconstruction using patellar tendon allograft: an age-dependent outcome evaluation. Arthroscopy 2010; 26 (4) 488-493
  • 13 Noh JH, Yang BG, Yi SR, Roh YH, Lee JS. Single-bundle anterior cruciate ligament reconstruction in active young men using bone-tendon Achilles allograft versus free tendon Achilles allograft. Arthroscopy 2013; 29 (3) 507-513
  • 14 Lawhorn KW, Howell SM, Traina SM, Gottlieb JE, Meade TD, Freedberg HI. 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 2012; 28 (8) 1079-1086
  • 15 Lee JH, Bae DK, Song SJ, Cho SM, Yoon KH. Comparison of clinical results and second-look arthroscopy findings after arthroscopic anterior cruciate ligament reconstruction using 3 different types of grafts. Arthroscopy 2010; 26 (1) 41-49
  • 16 Poehling GG, Curl WW, Lee CA , et al. Analysis of outcomes of anterior cruciate ligament repair with 5-year follow-up: allograft versus autograft. Arthroscopy 2005; 21 (7) 774-785
  • 17 Mascarenhas R, Tranovich M, Karpie JC, Irrgang JJ, Fu FH, Harner CD. Patellar tendon anterior cruciate ligament reconstruction in the high-demand patient: evaluation of autograft versus allograft reconstruction. Arthroscopy 2010; 26 (9, Suppl): S58-S66
  • 18 Carey JL, Dunn WR, Dahm DL, Zeger SL, Spindler KP. A systematic review of anterior cruciate ligament reconstruction with autograft compared with allograft. J Bone Joint Surg Am 2009; 91 (9) 2242-2250
  • 19 Lamblin CJ, Waterman BR, Lubowitz JH. Anterior cruciate ligament reconstruction with autografts compared with non-irradiated, non-chemically treated allografts. Arthroscopy 2013; 29 (6) 1113-1122
  • 20 Brown CA, McAdams TR, Harris AH, Maffulli N, Safran MR. ACL reconstruction in patients aged 40 years and older: a systematic review and introduction of a new methodology score for ACL studies. Am J Sports Med 2013; 41 (9) 2181-2190
  • 21 Mariscalco MW, Magnussen RA, Mehta D, Hewett TE, Flanigan DC, Kaeding CC. Autograft versus nonirradiated allograft tissue for anterior cruciate ligament reconstruction: a systematic review. Am J Sports Med 2014; 42 (2) 492-499
  • 22 Ghodadra NS, Mall NA, Grumet R , et al. Interval arthrometric comparison of anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft versus allograft: do grafts attenuate within the first year postoperatively?. Am J Sports Med 2012; 40 (6) 1347-1354
  • 23 Barrett G, Stokes D, White M. Anterior cruciate ligament reconstruction in patients older than 40 years: allograft versus autograft patellar tendon. Am J Sports Med 2005; 33 (10) 1505-1512
  • 24 Spindler KP, Huston LJ, Wright RW , et al; MOON Group. The prognosis and predictors of sports function and activity at minimum 6 years after anterior cruciate ligament reconstruction: a population cohort study. Am J Sports Med 2011; 39 (2) 348-359
  • 25 Guo L, Yang L, Duan XJ , et al. Anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft: comparison of autograft, fresh-frozen allograft, and γ-irradiated allograft. Arthroscopy 2012; 28 (2) 211-217
  • 26 Pallis M, Svoboda SJ, Cameron KL, Owens BD. Survival comparison of allograft and autograft anterior cruciate ligament reconstruction at the United States Military Academy. Am J Sports Med 2012; 40 (6) 1242-1246
  • 27 Baer GS, Harner CD. Clinical outcomes of allograft versus autograft in anterior cruciate ligament reconstruction. Clin Sports Med 2007; 26 (4) 661-681