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. Hypothesis: 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. Study Design: Cohort study; Level of evidence, 2. Method: 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. Conclusion: Based on the data, it would appear that the regular use of bone-patellar tendon-bone allografts, particularly for physically active patients, is unsuitable.