title: Anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft: comparison of autograft, fresh-frozen allograft, and γ-irradiated allograft.
abstract: OBJECTIVE
  To compare clinical follow-up results of anterior cruciate ligament (ACL) reconstruction using (1) autologous, (2) fresh-frozen allogeneic, and (3) γ-irradiated allogeneic bone-patellar tendon-bone (BPTB).
  
  
  METHODS
  From February 2002 to January 2006, 187 patients received BPTB ACL reconstruction at our center. One hundred forty-two consecutive patients who had received single-bundle BPTB ACL reconstruction were included in this study. Of these patients, 41 had autografts, 33 had fresh-frozen allografts, and 68 had γ-irradiated allografts. Clinical results were evaluated with the KT-1000 maximum displacement test (MEDmetric, San Diego, CA), Lachman test, and Lysholm, Irrgang, and Larson activity scales.
  
  
  RESULTS
  The mean duration of follow-up was 6.7 ± 1.5 years (range, 4.2 to 8.2 years). There were 3 cases of acute synovitis due to immunologic rejection (fresh-frozen allografts) and 6 cases of failure (γ-irradiated allografts). KT-1000 examination showed more anterior laxity in the γ-irradiated allograft group compared with the autograft and fresh-frozen allograft groups (P < .05). The Lysholm, Irrgang, and Larson activity scales showed no difference among the 3 groups (P > .05).
  
  
  CONCLUSIONS
  The study showed a statistically poorer KT-1000 result and higher failure rate in the γ-irradiated allograft group compared with the autograft and fresh-frozen allograft groups. This may suggest that γ-irradiated allograft is not a good candidate graft for ACL reconstruction. Power analysis showed that the study was underpowered, so further research and longer follow-up study are needed to make this point clearer.
  
  
  METHODS
  Level III, retrospective comparative study.
authors.affiliation: Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China. guolin6212@163.com
authors.forename: Lin
authors.initials: L
authors.lastname: Guo
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
authors.forename: Xiao-jun
authors.initials: XJ
authors.lastname: Duan
authors.forename: Rui
authors.initials: R
authors.lastname: He
authors.forename: Guang-xing
authors.initials: GX
authors.lastname: Chen
authors.forename: Fu-you
authors.initials: FY
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D001182:Arthroscopy; D050376:Bone-Patellar Tendon-Bone Grafting / Q000009:adverse effects; D005260:Female; D005615:Freezing; D005720:Gamma Rays; D006085:Graft Survival; D006801:Humans; D008297:Male; D013242:Sterilization; D014021:Tissue Preservation; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D055815:Young Adult