Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction

Harner, Christopher D.; Olson, Eric J.; Irrgang, James J.; Silverstein, Scott; Fu, Freddie H.; Silbey, Mark B

doi:10.1097/00003086-199603000-00016

Cited by 254 publications

(185 citation statements)

References 18 publications

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“…As several studies (Harner et al, 1996;Shelton et al, 1997;Peterson et al, 2001;Rihn et al, 2006) reported, we found that individuals who had an autograft reconstruction had more significant numbness and dysesthesia in the area of the incision than individuals who underwent allograft reconstruction, but there was no difference in patient-reported kneeling problems.…”

Section: Discussionsupporting

confidence: 50%

“…Many studies reported that the ACL reconstruction with BPTB autograft produced good clinical results (Harner et al, 1996;Fu et al, 2000;Deehan et al, 2000;Gorschewsky et al, 2007;Han et al, 2008). However, a desire to avoid the sacrifice of autologous tissue and to minimize surgical trauma and postoperative donor site morbidity has promoted the consideration of alternative graft sources (Stringham et al, 1996;Siebold et al, 2003;Barrett et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

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ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft

Kim

Tian

Zhang

et al. 2009

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To analyze the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with irradiated bone-patellar tendon-bone (BPTB) allograft compared with non-irradiated allograft and autograft. Methods: All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution. A total of 68 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into one of the two groups (autograft and irradiated allograft groups). The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months of follow-up (ranging from 24 to 47 months), patients were evaluated by the same observer according to objective and subjective clinical evaluations. Results: Of these patients, 65 (autograft 33, irradiated allograft 32) were available for full evaluation. When the irradiated allograft group was compared to the autograft group at the 31-month follow-up by the Lachman test, the anterior drawer test (ADT), the pivot shift test, and KT-2000 arthrometer test, statistically significant differences were found. Most importantly, 87.8% of patients in the autograft group and just only 31.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft (34.4%) was higher than that with autograft (6.1%). The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Documentation Committee (IKDC), functional and subjective evaluations, and activity level testing, no statistically significant differences were found between the two groups. Besides, patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever. When the patients had a fever, the laboratory examinations of all patients were almost normal. Blood routine was normal, the values of erythrocyte sedimentation rate (ESR) were 5~16 mm/h and the contents of C reactive protein (CRP) were 3~10 mg/L. Conclusion: We conclude that the short term clinical outcomes of the ACL reconstruction with irradiated BPTB allograft were adversely affected. The less than satisfactory results led the senior authors to discontinue the use of irradiated BPTB allograft in ACL surgery and not to advocate using the gamma irradiation as a secondary sterilizing method.

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Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft

Kim

Tian

Zhang

et al. 2009

J. Zhejiang Univ. Sci. B

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“…Allografts eliminate harvest morbidity and reportedly allow faster rehabilitation, earlier return to full activity, and possible cost reduction [4,10,25]. Disadvantages of using allografts, however, include potential disease transmission and prolonged graft healing [7,11,22,26,31,33].…”

Section: Introductionmentioning

confidence: 99%

Remodeling of ACL Allografts is Inhibited by Peracetic Acid Sterilization

Scheffler

Gonnermann

Kamp

et al. 2008

Clin Orthop Relat Res

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Sterilization of allografts for anterior cruciate ligament (ACL) reconstruction has become an important prerequisite to prevent disease transmission. However, current sterilization techniques impair the biological or mechanical properties of such treated grafts. Peracetic acid (PAA) has been successfully used to sterilize bone allografts without these disadvantages and does not impair the mechanical properties of soft tissue grafts in vitro. We asked whether PAA sterilization would influence recellularization, restoration of crimp length and pattern, and revascularization of ACL grafts during early healing. We used an in vivo sheep model for open ACL reconstruction. We also correlated the histologic findings with the restoration of anteroposterior stability and structural properties during load-to-failure testing. PAA slowed remodeling activity at 6 and 12 weeks compared to nonsterilized allografts and autografts. The mechanical properties of PAA grafts were also reduced compared to these control groups at both time points. We conclude PAA sterilization currently should not be used to sterilize soft tissue grafts typically used in ACL reconstruction.

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“…Greft seçimi, cerrahi deneyim, tercih, doku durumu, hastanın yaşı, aktivite durumu, eş-lik eden hastalıklar, cerrahi öncesi durum ve hastanın kararına bağlıdır. [2][3][4]15,16] ÖÇB rekonstrüksiyonunda altın standart olarak kabul edilen KPTK otogreftler; kemik tünellerde kemikkemiğe kaynama nedeniyle adaptasyon süresini kısalt-ması ve rijit tespitlerle kullanılabilmesi gibi avantajlarının yanında birçok dezavantajı vardır. Bunlar, kuadriseps kas gücü zafiyeti, ekstansiyon kaybı, diz önü ağrısı gibi birçok istenmeyen komplikasyonlardır.…”

Section: Discussionunclassified

“…Bununla birlikte rekonstrüksiyonun nasıl ve ne ile yapı-lacağı konusu halen tartışmalıdır. [3][4][5][6][7][8] ÖÇB rekonstrüksiyonunda altın standart olarak gö-rülen kemik-patellar tendon-kemik (KPTK) otogrefti kullanılmasını takiben diz önü ağrısı gibi istenmeyen sorunlar oluşabileceği gösterilmiştir. Dörtlü hamstring (semitendinözis-grasilis) tendon (DHT) otogrefti ile tedavide patellofemoral ağrı ve ekstansiyon kaybı-nın daha az olduğu bildirilmiştir.…”

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Anterior cruciate ligament injuries: do affect surgical treatment with otograft and allograft options, clinical results?

Aslan¹,

Özer²,

Baydar³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇBu çalışmada, allogreft ya da otogreft ile ön çapraz bağ (ÖÇB) rekonstrüksiyonun klinik sonuçları araştırıldı. GEREÇ VE YÖNTEMAnterior tibial tendon (ATT) allogreft (n=52) ya da dörtlü hamstring (DHT) otogreft (n=30) ile ön çapraz bağ (ÖÇB) rekonstrüksiyonu uygulanan 82 hastanın sonuçları geriye dönük olarak değerlendirildi. Hastalar son kontrolde, Uluslararası Diz Dokümantasyon Komitesi'nin (IKDC) diz skoru ve Lysholm skoru, performans (tek bacak zıplama) ve laksite (pivot-shift, Lachman, öne çekmece) testleri ile değerlendirildi. BULGULARİki grup arasında yaş, cinsiyet dağılımı, ameliyat edilen taraf, ameliyat öncesi süre ve eşlik eden yaralanmalar açısın-dan farklılık yoktu (p>0,05). IKDC, Lysholm, performans ve laksite bakımndan her iki grupta da sonuçlar tatmin ediciydi ancak gruplar arasında anlamlı fark yoktu (p>0,05). Fakat, ATT allogreft grubunda DHT otogreft grubuna göre daha fazla effüzyona rastlandı. SONUÇBu çalışmanın sonuçları ATT allogreft ya da DHT otogreft ile ÖÇB rekonstrüksiyonunun klinik sonuçlarının benzer olduğunu göstermektedir. Bununla birlikte allogreftlerde görülen immün yanıta çözümler geliştirilmesiyle ÖÇB rekonstrüksi-yonunda iyi bir greft alternatifi olabileceğini düşünüyoruz.Anahtar Sözcükler: Anterior tibial tendon allogreft; hamstring tendon otogreft; ön çapraz bağ yaralanması.

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Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction

Cited by 254 publications

References 18 publications

ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft

ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft

Remodeling of ACL Allografts is Inhibited by Peracetic Acid Sterilization

Anterior cruciate ligament injuries: do affect surgical treatment with otograft and allograft options, clinical results?

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