2017 ISAKOS Biennial Congress ePoster #1093

 

Allograft Usage Results in Higher Re-Revision Rate for Revision Anterior Cruciate Ligament Reconstruction

Kåre Amtoft Nissen, cand.med, Aarhus DENMARK
Torsten G. Nielsen, BSc, Aarhus N DENMARK
Martin Lind, MD, PhD, Prof., Aarhus N DENMARK

Aarhus University Hospital, Aarhus, Østjylland, DENMARK

FDA Status Not Applicable

Summary

To investigate whether allograft has a higher revision rate than autograft for revision ACL reconstruction, and display possible differences in knee stability and PROM

Abstract

Allograft usage results in higher re-revision rate for revision anterior cruciate ligament reconstruction

Kåre A. Nissen,
Torsten Grønbech Nielsen,
Martin Lind Department of Orthopedics,
Aarhus University Hospital, Aarhus, Denmark

Introduction

Allograft (AL) for anterior cruciate ligament reconstruction (ACL-R) can result in increased failure rates due to inferior biomechanical properties compared to autograft (AU) for primary ACL-R. AL is primarily used for revision ACL-R and the outcome of AL usage is poorly investigated. The Danish ACL Reconstruction Registry (DKRR) has monitored the development in ACL reconstructions since 2005. This registry study compares clinical outcomes and re-revision rates for revision ACL-R using AL or AU.

Methods

1619 revisions ACL-R were identified in the DKRR. These were 1315 AU procedures and 221 AL procedures. Clinical outcome after 1 year was reported using the Knee Injury and Osteoarthritis Outcome Score (KOOS), as well as Tegner function score (TFC) and objective knee stability (OKS) measurement using instrumented sagittal knee laxity side to side difference. Failure was determined as re-revision after minimum two years follow-up.

Results

At one-year follow-up the KOOS subscores for (symptoms, pain, ADL, Sport, QOL) were 67, 76, 84, 49, 46 for AL and 67, 78, 84, 51, 48 for AU with no difference between groups. OKS was 1,9±2mm for AL and 1,7±1,9mm for AU. The re-revision rate was significantly higher for AL of 12,7% compared to 5,4% for AU.

Conclusion

In this observational population-based study the re-revision rate was 2,3 times higher for AL compared to AU. However, subjective clinical outcome and knee stability were not inferior for AL patients, these results might indicate that AU is a safer graft choice for revision ACL-R.