The purpose of this study was to assess factors associated with patient selection of graft type for anterior cruciate ligament (ACL) reconstruction.
We retrospectively identified 1,038 patients who underwent ACL reconstruction over a 5-year period. Surgery was performed by 5 different surgeons. A questionnaire was sent to patients at a minimum of 24 months' follow-up to determine which type of graft was used, why they chose that graft, whether they were satisfied with their graft and outcome, and whether they would choose another graft and, if so, which one; it also included a visual analog scale to rate their recovery.
Questionnaires were received from 240 patients. The mean follow-up from the time of surgery was 41.3 months (range, 24 to 96 months). There were a variety of allografts and autografts used. Overall, allograft was used in 63.3% of patients and autograft in 35.4%. The most common factor influencing graft selection was physician recommendation (74.2%). Patients rated their recovery on average as 8.48 (±1.8) out of 10 on the visual analog scale (range, 0 to 10). Of the patients, 93% were satisfied with their graft selection. Only 12.7% would choose another graft if in the situation again. Of these patients, 63.3% would change from an autograft to allograft.
This study suggests that the most important factor for a patient choosing a graft for ACL reconstruction is physician recommendation. Our study has shown an increasing trend in our group toward the use of allograft materials for ACL reconstruction (63.3% of all graft materials selected). Of the individuals who were dissatisfied with their graft, 63% who originally chose autograft would choose allograft as a source in the future.
Level of Evidence
Level III, prognostic case-control study.
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- Clinical outcomes of allograft versus autograft in anterior cruciate ligament reconstruction.Clin Sport Med. 2007; 26: 661-681
- Allograft safety in anterior cruciate ligament reconstruction.Clin Sport Med. 2007; 26: 597-605
- Arthroscopic anterior cruciate ligament reconstruction: A meta-analysis comparing patellar tendon and hamstring tendon autografts.Am J Sports Med. 2003; 31: 2-11
- Bone-patella tendon-bone autograft anterior cruciate ligament reconstruction.Clin Sport Med. 2007; 26: 525-547
- Anterior cruciate ligament reconstruction using one-third of the patellar ligament, augmented by extra-articular tendon transfers.J Bone Joint Surg Am. 1982; 64: 352-359
- Anatomic endoscopic anterior cruciate ligament reconstruction.Orthop Clin North Am. 2002; 33: 717-725
- Ligament stability two to six years after anterior cruciate ligament reconstruction with autogenous patellar tendon graft and participation in accelerated rehabilitation program.Am J Sports Med. 1995; 23: 575-579
- Late patellar tendon ruptures after removal of the central third for anterior cruciate ligament reconstruction.Am J Sports Med. 1996; 24: 698-701
- Freeze-dried allografts for anterior cruciate ligament reconstruction.Clin Sport Med. 2007; 26: 625-637
- Graft selection in anterior cruciate ligament reconstruction.Orthop Clin North Am. 2002; 33: 675-683
- Transmission of disease through transplantation of musculoskeletal allografts: Current concepts review.J Bone Joint Surg Am. 1995; 77: 1742-1754
- Use of allografts in knee reconstruction: I. Basic science aspects and current status.J Am Acad Orthop Surg. 1998; 6: 165-168
- Transmission of human immunodeficiency virus type I from a seronegative organ and tissue donor.N Engl J Med. 1992; 326: 726-732
- Transplantation of musculoskeletal tissues.in: Simon S.R. Orthopaedic basic science: Biology and biomechanics of the musculoskeletal system. American Academy of Orthopaedic Surgeons, Rosemont2000: 567-579
- Human immunodeficiency virus cultured from bone.Clin Orthop Relat Res. 1990; : 249-253
- Analysis of outcomes of anterior cruciate ligament repair with 5-year follow-up.Arthroscopy. 2005; 21: 774-785
- Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction: A 5-year follow-up.Arthroscopy. 2001; 17: 9-13
- Autograft versus allograft anterior cruciate ligament reconstruction.Arthroscopy. 1997; 13: 446-449
Accepted: February 17, 2009
Received: July 26, 2008
The authors report no conflict of interest.
© 2009 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.