Clinical comparison of the Tutoplast allograft and autologous patellar tendon (bone-patellar tendon-bone) for the reconstruction of the anterior cruciate ligament: 2- and 6-year results.
BACKGROUND
The use of an allograft as a suitable transplant is still open to debate, in terms of donor morbidity, implantation reaction, and long-term results, as well as the risk of disease transmission.


OBJECTIVE
The clinical results 2 and 6 years after implantation of a bone-patellar tendon-bone allograft (Tutoplast) and bone-patellar tendon-bone autograft show no significant difference in relation to stability, function, and rate of rupture.


METHODS
Cohort study; Level of evidence, 2.


METHODS
Between 1995 and 1998, 268 patients with anterior cruciate ligament ruptures were surgically treated: 132 patients received a bone-patellar tendon-bone allograft implantation and 136 patients a bone-patellar tendon-bone autograft. The results were evaluated using the International Knee Documentation Committee, Noyes, and Lysholm scores.


RESULTS
There were 201 patients assessable after 2 years and 186 patients after 6 years. Ruptures of the implants in the allograft group occurred in 20 patients (20.6%) within 2 years and in 38 patients (44.7%) after 6 years. In the autograft group, transplants ruptured in 5 patients (4.8%) after 2 years and in 6 patients (5.9%) after 6 years.


CONCLUSIONS
Based on the data, it would appear that the regular use of bone-patellar tendon-bone allografts, particularly for physically active patients, is unsuitable.
Gorschewsky
Ottmar
O
Sportorthopädie Bern, Klinik Sonnenhof, Buchserstrasse 30, CH-3006 Bern, Switzerland. ottmargorschewsky@sonnenhof.ch
Klakow
Andreas
A
Riechert
Kathrin
K
Pitzl
Martin
M
Becker
Roland
R
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D019651:Plastic Surgery Procedures; D012421:Rupture; D013242:Sterilization; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome