Anterior Cruciate Ligament Graft Failure

Barrett, Austin M.; Craft, Jason A.; Replogle, William H.; Hydrick, Josie M.; Barrett, Gene R.

doi:10.1177/0363546511415655

Cited by 117 publications

(67 citation statements)

References 22 publications

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“…Barrett et al 2 showed at a minimum 2-year follow-up that patients younger than 25 years (mean age, 18 years) had significantly increased failure rates regardless of graft type. Reported failure rates for patients younger than 25 years were 12% for patellar tendon autografts, 25% for hamstring tendon auto-grafts, and 29% for allografts.…”

Section: Discussionmentioning

confidence: 99%

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Autograft Versus Nonirradiated Allograft Tissue for Anterior Cruciate Ligament Reconstruction

et al. 2013

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Background An autograft has traditionally been the gold standard for anterior cruciate ligament reconstruction (ACLR), but the use of allograft tissue has increased in recent years. While numerous studies have demonstrated that irradiated allografts are associated with increased failure rates, some report excellent results after ACLR with nonirradiated allografts. The purpose of this systematic review was to determine whether the use of nonirradiated allograft tissue is associated with poorer outcomes when compared with autografts. Hypothesis Patients undergoing ACLR with autografts versus nonirradiated allografts will demonstrate no significant differences in graft failure risk, laxity on postoperative physical examination, or differences in patient-oriented outcome scores. Study Design Systematic review. Methods A systematic review was performed to identify prospective or retrospective comparative studies (evidence level 1, 2, or 3) of autografts versus nonirradiated allografts for ACLR. Outcome data included graft failure based on clinical findings and instrumented laxity, postoperative laxity on physical examination, and patient-reported outcome scores. Studies were excluded if they did not specify whether the allograft had been irradiated. Quality assessment and data extraction were performed by 2 examiners. Results Nine studies comparing autografts and nonirradiated allografts were included. Six of the 9 studies compared bone– patellar tendon–bone (BPTB) autografts with BPTB allografts. Two studies compared hamstring tendon autografts to hamstring tendon allografts, and 1 study compared hamstring tendon autografts to tibialis anterior allografts. The mean patient age in 7 of 9 studies ranged from 24.5 to 32 years, with 1 study including only patients older than 40 years and another not reporting patient age. The mean follow-up duration was 24 to 94 months. Six of 9 studies reported clinical graft failure rates, 8 of 9 reported postoperative instrumented laxity measurements, 7 of 9 reported postoperative physical examination findings, and all studies reported patient-reported outcome scores. This review demonstrated no statistically significant difference between autografts and nonir-radiated allografts in any outcome measure. Conclusion No significant differences were found in graft failure rate, postoperative laxity, or patient-reported outcome scores when comparing ACLR with autografts to nonirradiated allografts in this systematic review. These findings apply to patients in their late 20s and early 30s. Caution is advised when considering extrapolation of these findings to younger, more active cohorts.

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Section: Discussionmentioning

confidence: 99%

“…This left a total of 21 comparative studies. Twelve of the 21 studies were excluded for not specifying whether the allografts had been irradiated (n = 6) 2,21,22,25,29,33 or including allografts that had been irradiated (n = 6). 6,11,26,36,37,39 The 9 remaining studies compared autograft and nonirradiated allograft tissue.…”

Section: Methodsmentioning

confidence: 99%

Autograft Versus Nonirradiated Allograft Tissue for Anterior Cruciate Ligament Reconstruction

et al. 2013

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“…Identifying an optimal rehabilitation protocol may help to decrease rates of ACL-R failure, estimated from 3–10%, and even higher among young patients and those who return to high activity levels [2, 8, 9]. In fact, in a retrospective analysis of 1131 consecutive ACL-Rs performed at one institution over seven years, ACL graft failure occurred in 16% of patients under age 25 compared to 8.3% of those older than 25 years [10]. …”

Section: Introductionmentioning

confidence: 99%

A Novel Device to Apply Controlled Flexion and Extension to the Rat Knee Following Anterior Cruciate Ligament Reconstruction

Stasiak

Wiznia

Alzoobaee

et al. 2012

Journal of Biomechanical Engineering

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We designed and validated a novel device for applying flexion-extension cycles to a rat knee in an in-vivo model of anterior cruciate ligament reconstruction (ACL-R). Our device is intended to simulate rehabilitation motion and exercise post ACL-R to optimize physical rehabilitation treatments for the improved healing of tendon graft ligament reconstructions. The device was validated for repeatability of the knee kinematic motion by measuring the force versus angular rotation response from repeated trials using cadaver rats. The average maximum force required for rotating an ACL reconstructed rat knee through 100 degrees of flexion-extension was 0.4 N with 95 % variability for all trials within ±0.1 N

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“…ACL tears are one of the most frequent forms of knee ligament injury with an estimated 150,000–200,000 ACL tears occurring annually in the United States alone12. ACL tears have critical implications for the physiological biomechanics of the tibiofemoral joint, often leading to functional instability, damage to meniscus and articular cartilage and an increased risk for PTOA51314.…”

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confidence: 99%

Post-Traumatic Osteoarthritis in Mice Following Mechanical Injury to the Synovial Joint

Farooq

Duan

Quirk

et al. 2017

Sci Rep

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We investigated the spectrum of lesions characteristic of post-traumatic osteoarthritis (PTOA) across the knee joint in response to mechanical injury. We hypothesized that alteration in knee joint stability in mice reproduces molecular and structural features of PTOA that would suggest potential therapeutic targets in humans. The right knees of eight-week old male mice from two recombinant inbred lines (LGXSM-6 and LGXSM-33) were subjected to axial tibial compression. Three separate loading magnitudes were applied: 6N, 9N, and 12N. Left knees served as non-loaded controls. Mice were sacrificed at 5, 9, 14, 28, and 56 days post-loading and whole knee joint changes were assessed by histology, immunostaining, micro-CT, and magnetic resonance imaging. We observed that tibial compression disrupted joint stability by rupturing the anterior cruciate ligament (except for 6N) and instigated a cascade of temporal and topographical features of PTOA. These features included cartilage extracellular matrix loss without proteoglycan replacement, chondrocyte apoptosis at day 5, synovitis present at day 14, osteophytes, ectopic calcification, and meniscus pathology. These findings provide a plausible model and a whole-joint approach for how joint injury in humans leads to PTOA. Chondrocyte apoptosis, synovitis, and ectopic calcification appear to be targets for potential therapeutic intervention.

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Anterior Cruciate Ligament Graft Failure

Cited by 117 publications

References 22 publications

Autograft Versus Nonirradiated Allograft Tissue for Anterior Cruciate Ligament Reconstruction

Autograft Versus Nonirradiated Allograft Tissue for Anterior Cruciate Ligament Reconstruction

A Novel Device to Apply Controlled Flexion and Extension to the Rat Knee Following Anterior Cruciate Ligament Reconstruction

Post-Traumatic Osteoarthritis in Mice Following Mechanical Injury to the Synovial Joint

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