Anterior laxity and patient-reported outcomes 7 years after ACL reconstruction with a fresh-frozen tibialis allograft.

Meike, Emily; Howell, S.; Hull, M.; Howell, S M; Hull, M L

Purpose: After reconstructing a torn ACL with a soft tissue allograft, the long-term healing process of graft maturation following the short-term healing process of graft incorporation into the bone tunnels might lead to recurring instability and concomitant decreases in the activity level, function, and patient satisfaction. Relying on roentgen stereophotogrammetric analysis (RSA), the primary purpose was to determine whether anterior laxity increased and whether patient-reported outcomes declined between 1 and 7 years for a particular graft construct, surgical technique, and rehabilitation programme.Methods: Eighteen of 19 patients, who participated in an earlier RSA study which extended to 1 year after the surgical procedure, were contacted 7 years after the surgical procedure. An examiner, different from the treating surgeon, measured anterior laxity under 150 N of anterior force using RSA in 16 patients and obtained outcome scores in 17 patients. One patient moved abroad and could not be contacted. One patient reinjured his reconstructed ACL and was excluded.Results: The average increase in anterior laxity of 1.5 ± 2.1 mm between 1 and 7 years after surgery was not significant (p = 0.08), and the average increase in anterior laxity of 2.7 ± 2.3 mm between the day of surgery and 7 years was significant (p Conclusion: In demonstrating that the ACL graft construct remains functional in the long term, this study supports the use of a fresh-frozen tibialis allograft in patients with an average age of 37 years at the time of surgery when used in conjunction with a surgical technique which avoids roof and PCL impingement, uses slippage-resistant fixation devices, and allows brace-free, self-paced rehabilitation.Level Of Evidence: IV.

ANTERIOR cruciate ligament; BIOLOGICAL dressings; TRANSPLANTATION of organs, tissues, etc.; JOINT hypermobility; TIBIALIS anterior; DISEASES; PHYSIOLOGY; KNEE surgery; ANTERIOR cruciate ligament surgery; HOMOGRAFTS; PATIENT satisfaction; RADIOSTEREOMETRY; REHABILITATION

Knee Surgery, Sports Traumatology, Arthroscopy, 2017, Vol 25, Issue 5, p1500

0942-2056

Academic Journal

10.1007/s00167-016-4351-3