Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft Versus Allograft

Purpose

The purpose of this study was to analyze the clinical outcome of arthroscopic anterior cruciate ligament (ACL) reconstruction with bone–patellar tendon–bone autograft versus allograft.

Methods

Between May 2000 and June 2004, 172 patients undergoing arthroscopic bone–patellar tendon–bone ACL reconstruction were prospectively randomized into autograft (n = 86) or allograft (n = 86) groups. The senior surgeon performed all operations using the same surgical technique. Each fixation was performed by means of an interference screw. Patients were evaluated preoperatively and postoperatively at follow-up. Of the patients, 156 (76 in the autograft group and 80 in the allograft group) were available for full evaluation. Evaluations included a detailed history, physical examination, functional knee ligament testing, KT-2000 arthrometer testing (MEDmetric, San Diego, CA), Harner's vertical jump and Daniel's 1-leg hop tests, Lysholm score, Tegner score, International Knee Documentation Committee standard evaluation form, Cincinnati knee score, and radiograph.

Results

Demographic data were comparable between groups. The mean follow-up was 5.6 years for both groups. There were no statistically significant differences according to evaluations of outcome between the 2 groups except that patients in the allograft group had a shorter operation time and longer fever time postoperatively compared with the autograft group. The postoperative infection rates were 0% and 1.25% for the autograft group and allograft group, respectively. There was a significant difference (P < .05) in the development of osteoarthritis between the operated knee in comparison to the contralateral knee according to radiographs. However, no significant difference was found between the 2 groups at the final follow-up examination (P > .05).

Conclusions

Both groups of patients achieved almost the same satisfactory outcomes after a mean of 5.6 years of follow-up. Allograft is a reasonable alternative to autograft for ACL reconstruction.

Level of Evidence

Level II, prospective comparative study.

Key Words: ACL reconstruction, Patellar tendon, Autograft, Allograft, Clinical outcome