Anterior Cruciate Ligament Reconstruction Using a Combination of Autograft and Allograft Tendon: A MOON Cohort Study

被引:36
作者
Darnley, James E. [1 ,2 ]
Leger-St-Jean, Benjamin [1 ,2 ,3 ]
Pedroza, Angela D. [1 ,2 ]
Flanigan, David C. [1 ,2 ,3 ]
Kaeding, Christopher C. [1 ,2 ,3 ]
Magnussen, Robert A. [1 ,2 ,3 ]
机构
[1] Ohio State Univ, Wexner Med Ctr, Columbus, OH 43210 USA
[2] Ohio State Univ, OSU Sports Med, Sports Hlth & Performance Inst, Columbus, OH 43210 USA
[3] Ohio State Univ, Dept Orthopaed, Columbus, OH 43210 USA
关键词
ACL reconstruction; hybrid graft; allograft; outcomes; GAMMA-IRRADIATION; MECHANICAL-PROPERTIES; HAMSTRING AUTOGRAFT; FAILURE RATES; GRAFT SIZE; BONE; KNEE; PREDICTORS; REVISION; OUTCOMES;
D O I
10.1177/2325967116662249
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Anterior cruciate ligament (ACL) reconstruction with hamstring autografts less than 8.5 mm in diameter is associated with worse patient-reported outcome scores and increased risk of revision surgery compared with reconstructions performed with larger grafts. One proposed solution to small autograft harvest is to create a hybrid graft by augmenting autografts with allograft tissue to increase graft diameter. Purpose: To compare hybrid autograft/allograft ACL reconstruction to autograft ACL reconstruction, specifically analyzing the patient-reported outcome scores and the risk of revision surgery at 2 years postoperative. Study Design: Cohort study; Level of evidence, 3. Methods: From the years 2002 to 2009, a total of 34 patients were identified from a prospectively collected database as having undergone hybrid ACL reconstruction. Twenty-seven of 34 (79.4%) patients had a 2-year follow-up. These 27 patients were matched by age (within 1 year) and sex to 27 patients who underwent hamstring autograft ACL reconstruction during the same period. At the 2-year mark, revision surgery risk and patient-reported outcome scores were compared between the 2 groups. Results: The mean age for the hybrid and matched groups (SD) was 20.9 +/- 7.0 years. Both the hybrid and control groups had 17 males and 10 females. There was no significant difference in preoperative patient-reported outcome scores, meniscus tears, or cartilage lesions between the 2 groups. Graft size was larger in the hybrid group (9.5 +/- 0.6 mm) than in the autograft group (8.4 +/- 0.9 mm) (P < .001). At 2 years postoperative, patient-reported outcome scores were similar between the hybrid and autograft groups. Revision surgery was required in 5 (18.5%) patients who underwent hybrid reconstruction compared with 2 (7.4%) of those who underwent autograft reconstruction (P = .26). Conclusion: Patients who undergo ACL reconstruction with hybrid hamstring grafts and hamstring autografts report similar patient-reported outcome scores at 2 years postoperative but may be at increased risk for revision ACL reconstruction.
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页数:5
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共 25 条
[1]   The Swedish National Anterior Cruciate Ligament Register A Report on Baseline Variables and Outcomes of Surgery for Almost 18,000 Patients [J].
Ahlden, Mattias ;
Samuelsson, Kristian ;
Sernert, Ninni ;
Forssblad, Magnus ;
Karlsson, Jon ;
Kartus, Juri .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2012, 40 (10) :2230-2235
[2]   Effect of low dose and moderate dose gamma irradiation on the mechanical properties of bone and soft tissue allografts [J].
Balsly, Colleen R. ;
Cotter, Andrew T. ;
Williams, Lisa A. ;
Gaskins, Barton D. ;
Moore, Mark A. ;
Wolfinbarger, Lloyd, Jr. .
CELL AND TISSUE BANKING, 2008, 9 (04) :289-298
[3]   Trends in Anterior Cruciate Ligament Reconstruction in the United States [J].
Buller, Leonard T. ;
Best, Matthew J. ;
Baraga, Michael G. ;
Kaplan, Lee D. .
ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE, 2015, 3 (01) :1-8
[4]   Increased Failure Rates After Anterior Cruciate Ligament Reconstruction With Soft-Tissue Autograft-Allograft Hybrid Grafts [J].
Burrus, M. Tyrrell ;
Werner, Brian C. ;
Crow, Austin J. ;
Brockmeier, Stephen F. ;
Carson, Eric W. ;
Miller, Mark D. ;
Diduch, David R. .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2015, 31 (12) :2342-2351
[5]   The extracellular remodeling of free-soft-tissue autografts and allografts for reconstruction of the anterior cruciate ligament: a comparison study in a sheep model [J].
Dustmann, M. ;
Schmidt, T. ;
Gangey, I. ;
Unterhauser, F. N. ;
Weiler, A. ;
Scheffler, S. U. .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2008, 16 (04) :360-369
[6]   GAMMA-IRRADIATION - EFFECTS ON BIOMECHANICAL PROPERTIES OF HUMAN BONE-PATELLAR TENDON-BONE ALLOGRAFTS [J].
FIDELER, BM ;
VANGSNESS, T ;
LU, B ;
ORLANDO, C ;
MOORE, T .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1995, 23 (05) :643-646
[7]   Reliability and validity of the International Knee Documentation Committee (IKDC) Subjective Knee Form [J].
Higgins, Laurence D. ;
Taylor, Marcus K. ;
Park, Daniel ;
Ghodadra, Neil ;
Marchant, Milford ;
Pietrobon, Ricardo ;
Cook, Chad .
JOINT BONE SPINE, 2007, 74 (06) :594-599
[8]   A COMPARISON OF PATELLAR TENDON AUTOGRAFT AND ALLOGRAFT USED FOR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN THE GOAT MODEL [J].
JACKSON, DW ;
GROOD, ES ;
GOLDSTEIN, JD ;
ROSEN, MA ;
KURZWEIL, PR ;
CUMMINGS, JF ;
SIMON, TM .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1993, 21 (02) :176-185
[9]   Risk Factors and Predictors of Subsequent ACL Injury in Either Knee After ACL Reconstruction: Prospective Analysis of 2488 Primary ACL Reconstructions From the MOON Cohort [J].
Kaeding, Christopher C. ;
Pedroza, Angela D. ;
Reinke, Emily K. ;
Huston, Laura J. ;
Spindler, Kurt P. .
AMERICAN JOURNAL OF SPORTS MEDICINE, 2015, 43 (07) :1583-1590
[10]   Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction: Predictors of Failure From a MOON Prospective Longitudinal Cohort [J].
Kaeding, Christopher C. ;
Aros, Brian ;
Pedroza, Angela ;
Pifel, Eric ;
Amendola, Annunziato ;
Andrish, Jack T. ;
Dunn, Warren R. ;
Marx, Robert G. ;
McCarty, Eric C. ;
Parker, Richard D. ;
Wright, Rick W. ;
Spindler, Kurt P. .
SPORTS HEALTH-A MULTIDISCIPLINARY APPROACH, 2011, 3 (01) :73-81