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Small Size Autograft versus Large Size Allograft in Anterior Cruciate Ligament Reconstruction

Clinics in Orthopedic Surgery 2021년 13권 1호 p.47 ~ 52
Kurtoglu Alper, Basar Betul, Basar Gokhan, Gezginaslan Omer, Basar Hakan,
소속 상세정보
 ( Kurtoglu Alper ) - Sakarya Training and Research Hospital Department of Orthopaedics and Traumatology
 ( Basar Betul ) - Gaziosmanpasa Training and Research Hospital Department of Physical Medicine and Rehabilitation
 ( Basar Gokhan ) - Umraniye Training and Research Hospital Department of Physical Medicine and Rehabilitation
 ( Gezginaslan Omer ) - Umraniye Training and Research Hospital Department of Physical Medicine and Rehabilitation
 ( Basar Hakan ) - Gaziosmanpasa Training and Research Hospital Department of Orthopaedics and Traumatology

Abstract


Background: A small autograft diameter negatively affects functional outcomes, knee stability, and the risk of rerupture after anterior cruciate ligament (ACL) reconstruction, whereas the strength of allograft decreases over time. Therefore, it is not clear whether the use of smaller autografts or the use of larger allografts in ACL yields better results. The aim of this study was to compare the outcome of smaller autografts and larger allografts for ACL reconstruction.

Methods: Fifty-one patients who underwent ACL reconstruction with hamstring tendon autografts (size ≤ 8 mm) and 21 patients who underwent ACL reconstruction with allografts (size ≥ 10 mm) were included in our study. All patients underwent the same aggressive early postoperative rehabilitation program. There were no significant differences between the autograft and allograft groups regarding the preoperative patient age, sex, time from injury to surgery, and average follow-up time.

Results: The mean diameter of the 4-stranded hamstring tendon grafts used as autografts was 7.48 ± 0.33 mm and the mean diameter of the allografts was 10.76 ± 0.67 mm. According to specific tests for the ACL (anterior drawer, Lachman, and pivot shift) and clinical evaluation tests (Lysholm knee scoring scale and International Knee Documentation Committee questionnaire), the final follow-up results were significantly better than the preoperative status in both autograft and allograft ACL reconstruction groups. Therefore, there were no significant differences between the autograft and allograft groups preoperatively and at the final follow-up.

Conclusions: The large size of the graft in ACL reconstruction has been reported to affect results positively. However, in our study, we could not find any significant differences between the smaller size autografts and larger size allografts in terms of inadequacy, rerupture, and final follow-up functional results. Although allografts were significantly larger than autografts, we did not have the positive effect of larger size grafts. Smaller size autografts were as effective as the larger size allografts.

키워드

Anterior cruciate ligament injury; Graft size; Allograft; Autograft

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