Document Detail

Allograft anterior cruciate ligament reconstruction in the young, active patient: tegner activity level and failure rate.
MedLine Citation:
PMID:  20952145     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: The purpose was to analyze outcomes of nonirradiated, fresh-frozen bone-patellar tendon-bone (BPTB) allograft anterior cruciate ligament (ACL) reconstruction in patients aged under 40 years with regard to activity level (Tegner score).
METHODS: Between 1993 and 2005, 111 patients, aged under 40 years, underwent primary, nonirradiated, fresh-frozen BPTB allograft ACL reconstruction and were retrospectively reviewed. Follow-up was limited to a minimum of 24 months. Patients with concomitant ligament injuries and previous surgeries were excluded. Seventy-eight patients met the inclusion criterion and were available for follow-up. Four hundred eleven patients had BPTB autograft ACL reconstructions and comprised the control group. Failure of the graft was defined as repeat ACL reconstruction because of reinjury or graft failure, 2+ Lachman (no endpoint), any pivot shift, and/or 5-mm side-to-side KT-1000 difference (MEDmetric, San Diego, CA) or greater. Initial examinations, surgical findings, and follow-up examinations were prospectively entered into a computerized relational database. The results were assessed by both objective and subjective measures.
RESULTS: High-activity allograft patients had a 2.6- to 4.2-fold increase in the probability of graft failure compared with low-activity BPTB allograft patients and low- and high-activity BPTB autograft patients. Patients undergoing BPTB autograft reconstruction reported significantly fewer problems on a visual analog scale and scored significantly higher on the postoperative Tegner activity scale than patients undergoing allograft reconstruction.
CONCLUSIONS: The active allograft group is 2.6 to 4.2 times more likely to fail compared with low-activity allografts and low- and high-activity autografts. We conclude that fresh-frozen BPTB allografts should not be used in young patients who have a high Tegner activity score because of their higher risk of failure.
LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Gene R Barrett; Kurre Luber; William H Replogle; Josie L Manley
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Publication Detail:
Type:  Journal Article     Date:  2010-10-16
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  26     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1593-601     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Inc.
Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, U.S.A.
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