Autograft versus allograft anterior cruciate ligament reconstruction

Abstract

To compare the efficacy of allograft versus autograft central one third patella bone-tendon-bone reconstruction of anterior cruciate ligaments (ACL), subjective and objective criteria were compared between two groups of 30 patients with 2-year follow-up. Over a 15-month period, 60 patients underwent ACL reconstruction with 30 allografts and 30 autografts. One surgeon performed all reconstructions, and interference fit screw fixation was used. An early rehabilitation protocol was instituted. At 3, 6, 12, and 24 months, allograft and autograft groups were compared based on side-to-side arthrometer difference, swelling, pain, range of motion, patellofermoral pain and crepitation, Lachman's test, pivot shift test, and side-to-side thigh circumference difference. Average age in the autograft group was 25 years (range, 15 to 43; standard deviation, 8.1), and in the allograft group was 27 years (range, 15 to 55; standard deviation, 10.9). Thirteen meniscectomies and 12 meniscal repairs were performed at the time of ACL autograft. Fifteen patients in the allograft group had meniscectomies, and 10 had meniscal repairs. There were 15 acute and 15 chronic injuries in the allograft group and 24 acute and 6 chronic in the autograft group. Results were analyzed using a chi-square test, and no statistical differences between groups were shown at 3, 6, 12, or 24 months for swelling, pain, side-to-side arthrometer difference, pivot shift test, range of motion, patellofermoral pain and crepitation, or Lachman's test comparisons. There was a trend for more of the allografts (20%) to have a glide on pivot shift at 24 months than autografts (7%). At 12 and 24 months, there was no difference in patellofermoral crepitus or thigh circumference. Complications included two patients with superficial infections.