| Allograft anterior cruciate ligament reconstruction in the young, active patient: tegner activity level and failure rate. | |
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MedLine Citation:
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PMID: 20952145 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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. |
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Authors:
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Gene R Barrett; Kurre Luber; William H Replogle; Josie L Manley |
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Publication Detail:
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Type: Journal Article Date: 2010-10-16 |
Journal Detail:
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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:
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Created Date: 2010-11-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8506498 Medline TA: Arthroscopy Country: United States |
Other Details:
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Languages: eng Pagination: 1593-601 Citation Subset: IM |
Copyright Information:
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Published by Elsevier Inc. |
Affiliation:
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Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, U.S.A. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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