Anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft versus allograft

Arthroscopy. 2009 Jul;25(7):750-9. doi: 10.1016/j.arthro.2008.12.023. Epub 2009 Apr 17.


Purpose: The purpose of this study was to analyze the clinical outcome of arthroscopic anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone autograft versus allograft.

Methods: Between May 2000 and June 2004, 172 patients undergoing arthroscopic bone-patellar tendon-bone ACL reconstruction were prospectively randomized into autograft (n = 86) or allograft (n = 86) groups. The senior surgeon performed all operations using the same surgical technique. Each fixation was performed by means of an interference screw. Patients were evaluated preoperatively and postoperatively at follow-up. Of the patients, 156 (76 in the autograft group and 80 in the allograft group) were available for full evaluation. Evaluations included a detailed history, physical examination, functional knee ligament testing, KT-2000 arthrometer testing (MEDmetric, San Diego, CA), Harner's vertical jump and Daniel's 1-leg hop tests, Lysholm score, Tegner score, International Knee Documentation Committee standard evaluation form, Cincinnati knee score, and radiograph.

Results: Demographic data were comparable between groups. The mean follow-up was 5.6 years for both groups. There were no statistically significant differences according to evaluations of outcome between the 2 groups except that patients in the allograft group had a shorter operation time and longer fever time postoperatively compared with the autograft group. The postoperative infection rates were 0% and 1.25% for the autograft group and allograft group, respectively. There was a significant difference (P < .05) in the development of osteoarthritis between the operated knee in comparison to the contralateral knee according to radiographs. However, no significant difference was found between the 2 groups at the final follow-up examination (P > .05).

Conclusions: Both groups of patients achieved almost the same satisfactory outcomes after a mean of 5.6 years of follow-up. Allograft is a reasonable alternative to autograft for ACL reconstruction.

Level of evidence: Level II, prospective comparative study.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anterior Cruciate Ligament / surgery*
  • Arthroscopy / methods
  • Athletic Injuries / surgery
  • Bone-Patellar Tendon-Bone Grafting / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Injuries / surgery*
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Prospective Studies
  • Recovery of Function
  • Rupture / surgery
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult