[Primary- and revision-reconstruction of the anterior cruciate ligament with allografts: a retrospective study including 325 patients].
At our institution we have used fresh-frozen allografts for the reconstruction of the anterior and posterior cruciate ligament since 1993.


METHODS
In this retrospective study we evaluated the clinical outcome of 325 fresh-frozen allografts (bone-patellar-tendon-bone allografts and Achilles-bone-tendon allografts) for primary and revision ACL-reconstruction. Patients (average age 38 years) were operated between 5/1993 and 2/1998 and mean follow-up was 38 (range 24 to 71) months. Clinical evaluation consisted of a case history, an examination, IKDC, Cincinnati knee score (CKS), KT-1000 testing and standardized X-rays.


RESULTS
Overall subjective rating according to the CKS was more than 82 points for both groups. Objective results according to the IKDC were normal or nearly normal in 75.6 % of primary- and 67.0 % of revision-ACL reconstructions. The stability measured with the KT-1000 showed an average maximum side to side difference of 2.1 mm for primary ACL reconstruction and 2.3 mm for revisioners. The total failure-rate (= rerupture-rate + laxity-failures) was 13.7 % for primary and 15.0 % for revision ACL reconstructions.


CONCLUSIONS
Given the increased failure-rate, autograft tissue remains our graft of first choice for primary ACL-reconstruction. We advise to reserve allografts for revision procedures where suitable autogenous tissues have been previously compromised, where a contraindication for autogenous tissue harvest exists or for multiple ligament surgery. No specific complications were observed with the use of allograft tissue.
Siebold
R
R
ARCUS-Sportklinik, Pforzheim, Germany. siebold7@aol.com
Buelow
J U
JU
Boes
L
L
Ellermann
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013709:Tendon Transfer / Q000379:methods*; D014184:Transplantation, Homologous