Patellar tendon anterior cruciate ligament reconstruction in the high-demand patient: evaluation of autograft versus allograft reconstruction

Arthroscopy. 2010 Sep;26(9 Suppl):S58-66. doi: 10.1016/j.arthro.2010.01.004.


Purpose: This study sought to compare patient-reported and objective outcomes in high-demand patients after anterior cruciate ligament reconstruction with either patellar tendon allograft or autograft by use of a matched-pairs case-control experimental design.

Methods: Nineteen matched pairs were obtained based on gender (36.8% female patients), age (27.9 +/- 8.1 years in autograft group v 28.1 +/- 9.1 years in allograft group), and length of follow-up (9.1 +/- 2.7 years in autograft group v 10.3 +/- 2.6 years in allograft group). All patients reported participating in very strenuous (soccer, basketball, and so on) or strenuous (skiing, tennis, and so on) sporting activity 4 to 7 times per week before their knee injury. Patient-reported outcomes included the International Knee Documentation Committee Subjective Knee Form, Activities of Daily Living and Sports Activity Scales of the Knee Outcome Survey, and Short Form 36. Clinical evaluation included knee range of motion, laxity, and functional strength.

Results: There were no statistically significant differences in gender, age, or body mass index. There was a slight difference in length of follow-up (P < .05). The groups showed no statistically significant differences in any of the patient-reported or objective outcome measures. More autograft patients reported that they were able to perform very strenuous activity without the sense of instability (14 v 7), but this difference only approached statistical significance (P < .07). Twelve autograft patients were able to return to preinjury levels of sporting activity compared with ten allograft patients. Sixteen autograft patients and twelve allograft patients were able to participate in strenuous or very strenuous sporting activity at follow-up. Both differences were not statistically significant.

Conclusions: Autograft and fresh-frozen allograft patellar tendon anterior cruciate ligament reconstruction exhibit similar patient-reported and objective outcomes in high-demand individuals at 3 to 14 years' follow-up.

Level of evidence: Level III, therapeutic case-control study.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries*
  • Arthroscopy*
  • Bone Screws
  • Bone-Patellar Tendon-Bone Grafting / methods*
  • Bone-Patellar Tendon-Bone Grafting / rehabilitation
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Motor Activity
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / epidemiology
  • Patellar Ligament / transplantation
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / epidemiology
  • Radiography
  • Recovery of Function
  • Retrospective Studies
  • Sports
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult