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

Am J Sports Med. 2005 Aug;33(8):1202-9. doi: 10.1177/0363546504271510. Epub 2005 Jul 6.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries*
  • Female
  • Humans
  • Knee Injuries / surgery*
  • Length of Stay
  • Male
  • Reconstructive Surgical Procedures
  • Rupture
  • Sterilization
  • Tendons / transplantation*
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome