1. ACL-Reconstruction Using Human Allograft
J. Buelow, R. Siebold, A. Ellermann
Arcus Sportklinik, Pforzheim, Germany
This Poster evaluates the outcome of 224 primary(group P) and 100 revision (group R) ACL–Reconstructions using human fresh –frozen BTB (n=265) and Achilles tendon(n=60) allografts .
The morbidity associated with autograft harvest has increased the interest in allografts. However, the decrease in tensile properties with sterilization and preservation as well as risk of inflammatory reaction has been a concern.
Fig.2: Interference screw and
staple fixation for AS- graft
Fig.1:Human fresh -frozen allograft
Methods: Clinical Evaluation included IKDC, CKS, KT-1000 and standardized x-rays. There were 224(69%) primary reconstructions (Group P) and 100 (31%) revisions (Group R). Patients (average age 38 yrs) were operated between 5/1993 and 2/ Mean f/u was 38 months(24-74).
Fig.3a+b: Interference screw fixation
for BTB graft
Fig.3b: BTB-graft
Results: Overall rating with the CKS(Fig.4) of 84 in group P and 82 in group R showed a high subjective acceptance of the procedure among the patients, with a high rate of return to pre-injury activity level. According to IKDC (Fig.5) 76% of group P and 67% of group R were in group A and B. Manual maximum KT-1000 side to side difference(Fig.6) at f/u was 2,1mm in primary reconstructions and 2,3mm in the revisions. Full extension was rapidly achieved in all cases and flexion averaged 135 degrees. There were 21 reruptures(Fig.6) in group P and 9 in group R (83% of these traumatic). No significant difference in clinical results could be seen between Achilles tendon and BTB grafts. There were no inflammatory reactions.
Fig.4: CKS at follow up
Fig.5: IKDC at follow up
Fig.6: Failures of 324 Allografts at f/u
Fig.5: KT-1000 at follow up
Discussion and Conclusion: Our study shows that favourable results can be obtained with Achilles tendon and BTB allografts and their use can be justified when the surgeon and patient choose this approach.
Arcus Sportklinik, Pforzheim, Germany