A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model.
Similar-sized patellar tendon autografts and fresh-frozen allografts were used to reconstruct the anterior cruciate ligament of one knee in 40 female goats. Evaluations of the reconstructions and contralateral controls at the 6-week and 6-month postoperative periods included anterior-posterior translation, mechanical properties determined during tensile failure tests, measurement of cross-sectional area, histology, collagen fibril size and area distribution, and associated articular cartilage degenerative changes. Six months after anterior cruciate ligament reconstruction, the autografts demonstrated a smaller increase in anterior-posterior displacement, values of maximum force to failure two times greater, a significant increase in cross-sectional area, a more rapid loss of large-diameter collagen fibrils, and an increased density and number of small-diameter collagen fibrils compared to the allografts. Clinical significance. More surgeons are allowing their patients to return to running and sports 6 months after anterior cruciate ligament reconstruction. While the structural and material properties of autografts and allografts at time zero are similar, in the goat model during the first 6 months they differ. The allografts demonstrate a greater decrease in their implantation structural properties, a slower rate of biologic incorporation, and the prolonged presence of an inflammatory response. At 6 months the autograft demonstrates a more robust biologic response, improved stability, and increased strength to failure values.
Jackson
D W
DW
Southern California Center for Sports Medicine, Long Beach Memorial Medical Center.
Grood
E S
ES
Goldstein
J D
JD
Rosen
M A
MA
Kurzweil
P R
PR
Cummings
J F
JF
Simon
T M
TM
D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D003094:Collagen; D005260:Female; D006041:Goats; D006614:Hindlimb / Q000601:surgery; D008854:Microscopy, Electron; D013710:Tendons / Q000473:pathology / Q000637:transplantation*; D013997:Time Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
D003094:Collagen