Introduction

Anterior Cruciate Ligament (ACL) rupture is common but severe injury and may lead to knee joint instability. Therefore, it requires surgical reconstruction in many cases to provide preinjury stability, especially for patients with a high level of activity. While arthroscopic reconstruction of the ACL is nowadays the gold standard, graft choice is mainly based on surgeon ´s preference. Quadriceps, hamstring and patella autograft tendons are most commonly used. Nowadays Allografts with the advantages of missing donor-site-morbidity, secured graft thickness, careful storage and unrestricted availability gaining upcoming popularity. The aim of this study was to evaluate clinical outcome and HRQOL of Allografts, compared to hamstring Autografts used in primary ACL reconstruction.

Material And Methods

A total of 17 patients were included in this present randomized prospective study during the follow-up period of 13 months. Allografts were used in 14 patients, whereas 13 patients were treated with a Hamstring-Autograft tendon. Preoperative, 6 and 12 weeks as well as 6 and 13 months postoperative all patients were examined regarding knee function, health related quality of life, range of motion, knee stability and pain. Therefore, the IKDC and the Tegner-Activity-Scale were applied. An MRI was made preoperative as well as six months and one year after surgery. Allografts processing was constant and the operation technique was the same in both groups.

Results

The postoperative results 13 months after surgery presented no statistically significant differences for the IKDC (p = 0.303) as well as for the Tegner-Activity-Scale (p= 0.596) between the two study groups. During the follow-up period a significant improvement was detected in the Autograft group (p=0.002). The Allograft group presented significantly worse postoperative IKDC results compared to the Autograft group (p=0.037). No instability or radiographic sign of re-rupture was detected in both groups. The operation time was significantly shorter in the Allograft group.

Discussion

This is one of the first studies prospectively comparing Allografts and Autografts in primary ACL reconstruction. Allografts provide equal postoperative results to hamstring Autografts in regarding functional parameters. Significantly better patient related results were measurable for Autografts. However, the use of Allografts presented a significantly shorter operation time. In conclusion, the use of Allografts in primary ACL reconstruction could be considered as an alternative to Autografts, however results in the long term have to be waited for.