Non-anatomic ACL Graft Placement Linked to Reduced Cartilage Thickness

Allograft Anterior Cruciate Ligament Reconstruction in Patients Younger Than 30 Years: A Matched-Pair Comparison of Bone– Patellar Tendon–Bone and Tibialis Anterior

We conducted a study to compare patient-reported outcomes and graft-rupture rates of bone–patellar tendon–bone (BPTB) and tibialis anterior (TA) allograft primary anterior cruciate ligament (ACL) reconstruction in patients younger than 30 years.

Patients were retrospectively identified as having undergone ACL reconstruction with either a BPTB (n = 20) or a TA (n = 20) allograft. Each patient in the BPTB group was matched to a patient in the TA group based on sex, age at time of surgery, height, weight, and preoperative activity level. The Lysholm Knee Scoring Scale and the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form were administered at a minimum of 1 year after surgery.

Mean Lysholm scores were 92.9 (BPTB) and 93.0 (TA), and mean IKDC scores were 92.6 (BPTB) and 90.3 (TA). The differences were not statistically significant. Overall
graft-rupture rates for the study period were 4.7% (BPTB) and 1.9% (TA) (P = .18). There was no statistically significant difference in patient-rated outcomes and
graft-rupture rates between BPTB and TA allografts for ACL reconstruction at a minimum of 1 year after surgery.

Future research efforts should focus on mid- and long-term follow-up and objective outcomes.

Am J Orthop. 2014;43(3):132-136.

Daniel F. O’Brien, BA, Matthew J. Kraeutler, BS, Loukas Koyonos, MD, Russell R. Flato, BA, Michael G. Ciccotti, MD, and Steven B. Cohen, MD