title: Bone-Albumin filling decreases donor site morbidity and enhances bone formation after anterior cruciate ligament reconstruction with bone-patellar tendon-bone autografts.
abstract: Donor site pain affects 32-43 % of patients after anterior cruciate ligament surgery when the autograft is freshly harvested bone-patellar tendon-bone tissue. Our aim was to compare functional and morphological differences between donor sites with and without serum albumin-coated bone allograft filling.
  
  
  
  After harvesting and implanting the graft, the tibia site was filled with either fresh autologous cancellous bone enhanced with albumin-coated allograft or autologous bone alone. The patella site was filled either with albumin-coated allograft or with blood clot. Knee function was evaluated by the VISA, Lysholm and IKDC scores and a visual analog scale of pain during standing, kneeling and crouching after six weeks and six months. Computed tomography was performed at six months for morphological evaluation.
  
  
  
  At six weeks, both groups were still recovering from surgery and the overall knee function was still impaired but the functional scores were significantly higher in the Bone-Albumin group. The pain with crouching and kneeling was also lower as compared to controls. At six months, the knee function scores were close to normal, with a slight decrease in the controls. Pain at kneeling was still prominent in the controls, but significantly lower in the Bone-Albumin group. Computed tomography showed significantly smaller bone defects and higher bone density in the Bone-Albumin group.
  
  
  
  Results from the present study indicate that donor site pain, a disturbing long-term side effect of bone-patellar tendon-bone surgery, is significantly reduced if bone buildup in the patella and the tibia is augmented by serum albumin-coated bone allografts.
authors.affiliation: Institute of Clinical Experimental Research, Semmelweis University, Budapest, Tűzoltó u. 37-47, 1094, Hungary.|Saint George University Teaching Hospital of County-Fejér, Székesfehérvár, Seregélyesi u. 3., 8000, Hungary.
authors.forename: Károly
authors.initials: K
authors.lastname: Schandl
authors.affiliation: Institute of Clinical Experimental Research, Semmelweis University, Budapest, Tűzoltó u. 37-47, 1094, Hungary.
authors.forename: Dénes B
authors.initials: DB
authors.lastname: Horváthy
authors.affiliation: Department of Transplantation and Surgery, Semmelweis University, Budapest, Baross u. 23-26, 1082, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Doros
authors.affiliation: Saint George University Teaching Hospital of County-Fejér, Székesfehérvár, Seregélyesi u. 3., 8000, Hungary.
authors.forename: Ernő
authors.initials: E
authors.lastname: Majzik
authors.affiliation: Institute of Clinical Experimental Research, Semmelweis University, Budapest, Tűzoltó u. 37-47, 1094, Hungary.
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Schwarz
authors.affiliation: West Hungarian Regional Tissue Bank, Petz Aladár County Hospital, Győr, Vasvári Pál u. 2-4, 9024, Hungary.
authors.forename: Lajos
authors.initials: L
authors.lastname: Csönge
authors.affiliation: Saint George University Teaching Hospital of County-Fejér, Székesfehérvár, Seregélyesi u. 3., 8000, Hungary.
authors.forename: Géza
authors.initials: G
authors.lastname: Abkarovits
authors.affiliation: Saint George University Teaching Hospital of County-Fejér, Székesfehérvár, Seregélyesi u. 3., 8000, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Bucsi
authors.affiliation: Institute of Clinical Experimental Research, Semmelweis University, Budapest, Tűzoltó u. 37-47, 1094, Hungary. zlacza@mac.com.
authors.forename: Zsombor
authors.initials: Z
authors.lastname: Lacza
mesh_terms: D000328:Adult; D000418:Albumins / Q000008:administration & dosage*; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D064592:Autografts; D016025:Bone Transplantation; D050376:Bone-Patellar Tendon-Bone Grafting / Q000379:methods*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology; D013977:Tibia / Q000503:physiopathology / Q000601:surgery*; D060053:Transplant Donor Site / Q000503:physiopathology / Q000601:surgery; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D000418:Albumins
keywords: Albumin; Anterior cruciate ligament; BTB; Bone allograft; Bone-Albumin; Bone-tendon-bone; Serum