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, 14 (1), 85

Allograft or Autograft in Skeletally Immature Anterior Cruciate Ligament Reconstruction: A Prospective Evaluation Using Both Partial and Complete Transphyseal Techniques

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Allograft or Autograft in Skeletally Immature Anterior Cruciate Ligament Reconstruction: A Prospective Evaluation Using Both Partial and Complete Transphyseal Techniques

Mohammad Razi et al. J Orthop Surg Res.

Abstract

Objective: We compared autografts and allograft using partial and complete transphyseal anterior cruciate ligament (ACL) reconstruction techniques among skeletally immature individuals.

Methods: Male and females younger than 18 and 16 years old, respectively, diagnosed with ACL tear from April 2006 to March 2012 entered the study. One group had four-strand hamstring autograft, and the other had tibialis posterior allograft reconstruction. Those who had allografts either had hyper-laxity or recurvatum.

Results: Achieved mean (± SD) 2000 International Knee Documentation Committee subjective score was not statistically different (P = 0.385) between allograft (n = 13) (84.3 ± 3.2) and autograft groups (n = 18) (85.6 ± 4.4). Mean Knee injury and Osteoarthritis Outcome Score (KOOS) subscale Knee-Related Quality of Life at 2 years was 78.0 ± 7.2 and 75 ± 7.4 for allograft and autograft groups, respectively (p = 0.261). Mean 2-year KOOS subscale Sports and Recreation was 82.1 ± 5.8 and 84.8 ± 6.6 for allograft and autograft groups, respectively (p = 0.244). No patient reported instability, giving way, or locking of the knee. Pivot shift test was negative in all patients; however, a minor positive Lachman test was found in six cases (46%) within the allograft group and seven cases (39%) in the autograft group. One postoperative septic arthritis was documented in the autograft group.

Conclusion: Considering existing concern that joint laxity and recurvatum are among the precursors of non-contact ACL injury in adolescents, bone-patellar-bone autografts are not applicable in this age group because of the open physis; furthermore, considering that hamstring autografts are insufficient (size thickness and stretchability), we recommend soft tissue allografts for ACL reconstruction in skeletally immature patients.

Keywords: Adolescent; Allograft; Anterior cruciate ligament; Autograft; Reconstruction.

Conflict of interest statement

Ethics approval and consent to participate

All subjects and their legal guardians gave their written and informed consent to take part in the study. As patients received their routine treatment, aside to patients consent no institutional ethics consent was sought. The study protocol was in coherence with the guidelines of the Declaration of Helsinki.

Consent for publication

All participants have given their informed consent for the publication of their data

Competing interests

The authors declare that they have no competing interest.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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References

    1. Buckle C, Wainwright A. A systematic review of long-term patient reported outcomes for the treatment of anterior cruciate ligament injuries in the skeletally immature. J Child Orthop. 2018;12(3):251–261. doi: 10.1302/1863-2548.12.170179. - DOI - PMC - PubMed
    1. Pennock A, Murphy MM, Wu M. Anterior cruciate ligament reconstruction in skeletally immature patients. Curr Rev Musculoskelet Med. 2016;9(4):445–453. doi: 10.1007/s12178-016-9367-2. - DOI - PMC - PubMed
    1. Trivedi V, Mishra P, Verma D. Pediatric ACL injuries: a review of current concepts. Open Orthop J. 2017;11:378–388. doi: 10.2174/1874325001711010378. - DOI - PMC - PubMed
    1. Werner BC, Yang S, Looney AM, Gwathmey FW. Trends in pediatric and adolescent anterior cruciate ligament injury and reconstruction. J Pediatr Orthop. 2016;36(5):447–452. doi: 10.1097/BPO.0000000000000482. - DOI - PubMed
    1. Dunn KL, Lam KC, Valovich McLeod TC. Early operative versus delayed or nonoperative treatment of anterior cruciate ligament injuries in pediatric patients. J Athl Train. 2016;51(5):425–427. doi: 10.4085/1062-6050.51.5.11. - DOI - PMC - PubMed

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