Post-operative complications following primary ACL reconstruction using allogenic and autogenic soft tissue grafts: Increased relative morbidity risk is associated with increased graft diameter

Background: Arthroscopic ACL reconstruction has become one of the most commonly performed arthroscopic surgeries. Inspite of extensive research on available autograft options, controversy still persists regarding the ideal graft. Allograft tendons usage in orthopedic operations has increased because of its advantages. This study was conducted to assess the functional outcome in patients undergoing ACL reconstruction with soft tissue allografts.Methods: 15 patients with Anterior Cruciate Ligament injury presenting from 2012-2014 who underwent Arthroscopic ACL reconstruction with soft tissue allograft were the subjects of this Prospective study. Assessment of the involved knee was performed to obtain subjective measures of the clinical outcomes of the ACL reconstruction. All patients were followed up at regular intervals of 3 weeks, 6 weeks, 12 weeks, 6 months and 2 years.Results: At the final follow up, the patients had an average Lysholm knee score of 85.60, Tegner score of 7.24 and IKDC score of 85.28. Knee flexion of >1200 was achieved in >80% of patients and minimal laxity in 60% patients but no functional disability in any of them. No graft failures were noted. Conclusions: Contrary to the fear of graft failure and complications associated with allograft construct for primary ACL reconstruction, allografts yield the same clinical outcome as autografts with the advantages of reduced operative time, no donor site morbidity, preservation of native hamstring tendons, faster and comfortable rehabilitation. Allografts are a good alternative to autografts for primary ACL reconstruction.

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“…18,19 Contrary to this historical popular belief, no patient in our allograft study group showed any signs of superficial or deep infection.…”

Section: Discussioncontrasting

confidence: 54%

Soft tissue allograft for primary anterior cruciate ligament reconstruction

et al. 2017

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“…Furthermore, allografts might significantly change the initial biomechanical properties after g-irradiation; whether the changes in biomechanical properties affect the clinical outcomes of ACL reconstruction with g-irradiated allograft still remains controversial. [7][8][9][10][11][12] The erythrocyte sedimentation rate (ESR) and Creaction protein (CRP) level are the most useful routine laboratory screening tests for diagnosing potential infection after surgery and determining the response to treatment. Previous studies have found similar clinical results between allograft and autograft.…”

mentioning

confidence: 99%

A Prospective Randomized Study of Anterior Cruciate Ligament Reconstruction With Autograft, γ-Irradiated Allograft, and Hybrid Graft

Wang

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…The rate of hardware removal is similar to other procedures, [6][7][8][9][10][11] such as anterior cruciate ligament (ACL) reconstructions, where screws or staple prongs are commonly proud or unicortical due to the nature of this type of hardware. [12][13][14] Hardware function (such as in ACL graft tunnel mismatch) must be considered, because repositioning of the hardware placed around an already well-secured surgical site or ACL graft could lead to significant graft damage. In reality, we all need to expect that some patients will require deep hardware removal because of the bulky fixation plates used, and this should not be considered a true "complication."…”

Section: See Related Article On Page 2141mentioning

confidence: 99%

Editorial Commentary: Limited Data Shows How Little We Know

Mitchell¹,

Chahla²,

LaPrade³

2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Lateral compartment osteoarthritis of the knee can be a challenging problem to address in the younger, active population. The challenge is compounded by limited treatment options and high patient expectations, with patients often desiring a return to impact high intensity activity. Distal femoral osteotomy has been reported to be one potential treatment option; however, a highly heterogeneous literature exists for both opening and closing wedge distal femoral osteotomies for the treatment of isolated lateral compartment osteoarthritis with valgus malalignment. The literature does not provide significant direction for surgeons on the appropriate surgical approach; however, opening wedge osteotomies allow for fine adjustment and maintain leg length and joint alignment, and are our preferred approach.

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Post-operative complications following primary ACL reconstruction using allogenic and autogenic soft tissue grafts: Increased relative morbidity risk is associated with increased graft diameter

Cited by 27 publications

References 36 publications

Soft tissue allograft for primary anterior cruciate ligament reconstruction

Soft tissue allograft for primary anterior cruciate ligament reconstruction

A Prospective Randomized Study of Anterior Cruciate Ligament Reconstruction With Autograft, γ-Irradiated Allograft, and Hybrid Graft

Editorial Commentary: Limited Data Shows How Little We Know

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