title: Arthroscopic anterior cruciate ligament reconstruction with at least 2.5 years' follow-up comparing hamstring tendon autograft and irradiated allograft.
abstract: OBJECTIVE
  To compare the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with hamstring tendon autograft versus irradiated allograft.
  
  
  METHODS
  All irradiated hamstring tendon allografts (gracilis and semitendinosus), which were sterilized with 2.5 Mrad of irradiation before distribution, were obtained from a single certified tissue bank. A total of 78 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into 1 of 2 groups: autograft and irradiated allograft. The same surgical technique was used in all operations, which were performed by the same senior surgeon. Before surgery and at a mean of 42.2 months of follow-up, patients were evaluated by the same observer according to objective and subjective clinical evaluations.
  
  
  RESULTS
  Of the patients, 67 (36 in autograft group and 31 in irradiated allograft group) were available for full evaluation. When the irradiated allograft group was compared with the autograft group at the final follow-up by the Lachman test, anterior drawer test, pivot-shift test, and KT-2000 arthrometer (MEDmetric, San Diego, CA) assessment, statistically significant differences were found (P = .00011, P = .00016, P = .008, and P = .00021, respectively). Most importantly, 86.1% of patients in the autograft group and only 32.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000 assessment. The rate of laxity (side-to-side difference >5 mm) with irradiated allograft (32.3%) was higher than that with autograft (8.3%). The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Documentation Committee rating, functional and subjective evaluations, and activity level testing, no statistically significant differences were found between the 2 groups. However, patients in the irradiated allograft group had a shorter operative time and a longer duration of postoperative fever. When the patients had a fever, the laboratory examination findings of all patients were almost normal (white blood cell count, normal; erythrocyte sedimentation rate, 8 to 20 mm/h; and C-reactive protein level, 4 to 11 mg/L).
  
  
  CONCLUSIONS
  The clinical outcome of ACL reconstruction with hamstring tendon autograft was satisfactory, whereas the difference in instrumented laxity between the 2 groups was significant and the difference in functional test results was not significant.
  
  
  METHODS
  Level II, prospective comparative study.
authors.affiliation: Department of Orthopaedics, The Affiliated Hospital of Qingdao University Medical College, Qingdao, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Sun
authors.forename: Jihua
authors.initials: J
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Changsuo
authors.initials: C
authors.lastname: Xia
authors.forename: Cailong
authors.initials: C
authors.lastname: Zhang
authors.forename: Tengbo
authors.initials: T
authors.lastname: Yu
authors.forename: Shaoqi
authors.initials: S
authors.lastname: Tian
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods* / Q000534:rehabilitation / Q000706:statistics & numerical data; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005334:Fever / Q000209:etiology; D005500:Follow-Up Studies; D005720:Gamma Rays; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D013242:Sterilization / Q000379:methods*; D013710:Tendons / Q000528:radiation effects / Q000637:transplantation*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult