Graft selection/fixation in revision anterior cruciate ligament surgery

Levy, Andrew; Ducey, Stephen

doi:10.1016/s1060-1872(98)80053-1

Operative Techniques in Sports Medicine

1998

DOI: 10.1016/s1060-1872(98)80053-1

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Graft selection/fixation in revision anterior cruciate ligament surgery

Andrew Levy¹,

Stephen Ducey²

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Cited by 2 publications

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“…However, allograft is frequently used for revision ACLR for numerous reasons, such as lack of suitable remaining autograft options, avoidance of additional donor-site morbidity, need to fill bone tunnels with tunnel widening, or need for large-diameter graft tissue. 7 , 11 , 17 In the United States, allografts have mainly been used for primary ACLR because of their high availability. The Multicenter Orthopedic Outcome Network (MOON) group has investigated a large US cohort of primary ACLRs and found an increased risk of reinjury with use of allograft.…”

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confidence: 99%

Allograft Use Results in Higher Re-revision Rate for Revision Anterior Cruciate Ligament Reconstruction

Nissen

Eysturoy

Nielsen

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:The literature on revision anterior cruciate ligament (ACL) reconstruction (ACLR) outcomes is generally sparse, but previous studies have demonstrated that autograft use results in improved sports function and patient-reported outcome measures compared with allograft. However, knowledge is still lacking regarding the impact of graft type on rates of re-revision.Purpose:To investigate the clinical outcomes and failure rates of revision ACLRs performed with either allograft or autograft.Study Design:Cohort study; Level of evidence, 3.Methods:A search of the Danish Knee Ligament Reconstruction Registry identified 1619 revision ACLRs: 1315 were autograft procedures and 221 were allograft procedures (type of graft was not identified for 83 procedures). Clinical outcomes after 1 year were reported via the Knee injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity score, and an objective knee stability measurement that determined side-to-side differences in instrumented sagittal knee laxity. Failure was determined as re-revision. Outcomes for revision were provided for the full life of the registry, up to 10 years.Results:The re-revision rate was significantly higher for allograft compared with autograft (12.7% vs 5.4%; P < .001), leading to a hazard ratio for re-revision of 2.2 (95% CI, 1.4-3.4) for allografts compared with autografts when corrected for age. At 1-year follow-up, objective knee stability was significantly different (2.1 ± 2.1 mm for allograft vs 1.7 ± 1.8 mm for autograft; P = .01), and the KOOS subscale scores for symptoms, pain, activities of daily living, sports, and quality of life were 67, 76, 84, 49, and 46 for allograft and 67, 78, 84, 51, and 48 for autograft, respectively, with no difference between groups.Conclusion:In this observational population-based study, the ALCR re-revision rate was 2.2 times greater for allograft compared with autograft procedures. Allograft was associated with greater knee laxity at 1-year follow-up. However, subjective clinical outcomes and knee function were not inferior for allograft patients. These results indicate that autograft is a better graft choice for revision ALCR.

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confidence: 99%

Allograft Use Results in Higher Re-revision Rate for Revision Anterior Cruciate Ligament Reconstruction

Nissen

Eysturoy

Nielsen

et al. 2018

Orthopaedic Journal of Sports Medicine

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Femoral Interference Screw Removal Complicating Revision Anterior Cruciate Ligament Reconstruction

Cosgarea

Thomas

Jones

2000

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Graft selection/fixation in revision anterior cruciate ligament surgery

Cited by 2 publications

References 31 publications

Allograft Use Results in Higher Re-revision Rate for Revision Anterior Cruciate Ligament Reconstruction

Allograft Use Results in Higher Re-revision Rate for Revision Anterior Cruciate Ligament Reconstruction

Femoral Interference Screw Removal Complicating Revision Anterior Cruciate Ligament Reconstruction

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