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Prospective Randomized Comparison of Knee Stability and Proprioception for Posterior Cruciate Ligament Reconstruction With Autograft, Hybrid Graft, and γ-Irradiated Allograft

  • Jia Li
    Affiliations
    Department of Orthopaedic Surgery and Key Laboratory of Orthopedic Biomechanics of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
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  • Fanlong Kong
    Affiliations
    Department of Orthopaedic Surgery and Key Laboratory of Orthopedic Biomechanics of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
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  • Xianda Gao
    Affiliations
    Department of Orthopaedic Surgery and Key Laboratory of Orthopedic Biomechanics of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
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  • Yong Shen
    Affiliations
    Department of Orthopaedic Surgery and Key Laboratory of Orthopedic Biomechanics of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
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  • Shijun Gao
    Correspondence
    Address correspondence to Shijun Gao, M.D., Third Hospital of Hebei Medical University, Shijiazhuang 050051, People's Republic of China.
    Affiliations
    Department of Orthopaedic Surgery and Key Laboratory of Orthopedic Biomechanics of Hebei Province, Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
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      Purpose

      To evaluate posterior stability and proprioception after arthroscopic posterior cruciate ligament reconstruction with autograft, hybrid graft, and γ-irradiated allograft.

      Methods

      This prospective, randomized controlled trial (with 5 years' follow-up) included 90 patients who underwent posterior cruciate ligament reconstruction with autograft (gracilis and semitendinosus tendons), hybrid graft (γ-irradiated tibialis anterior tendon allograft and semitendinosus tendon autograft), or γ-irradiated allograft (tibialis anterior tendons). All the γ-irradiated allografts (tibialis anterior tendons) received an irradiation dose of 2.5 Mrad before distribution. Patients in this study had undergone a preoperative magnetic resonance imaging scan and physical examination. Patients were excluded from the study if they had a concomitant injury to other knee ligaments, previous surgery on the injured knee, or articular cartilage lesions greater than Outerbridge grade II. Clinical and proprioceptive evaluation results were collected preoperatively and at 3, 6, 12, 24, 36, and 60 months after surgery.

      Results

      The autograft, allograft, and hybrid graft groups were followed up for 5.5 ± 0.2 months (range, 5 to 6 years), 5.7 ± 0.3 months (range, 5 to 6 years), and 5.6 ± 0.5 months (range, 5 to 6 years), respectively. No statistically significant differences were found among the 3 groups regarding preoperative demographic factors (P > .05). The differences in physical examination findings and subjective evaluations among the 3 groups were not significant (P > .05). However, a significant difference was detected in instrumented anteroposterior measurements, with more laxity shown in the γ-irradiated allograft group than in the other 2 groups (P = .006).

      Conclusions

      The differences in proprioceptive and functional outcomes among the 3 groups were not significant. In contrast, a significant difference was detected in instrumented anteroposterior measurements, which showed more laxity in the γ-irradiated allograft group than in the other 2 groups. However, this may not be clinically significant.

      Level of Evidence

      Level II, prospective comparative study.
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