Irradiated Hamstring Tendon Allograft Versus Autograft for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

Tian, Shuo; Wang, Bin; Liu, Lun; Wang, Yuanhe; Ha, Chengzhi; Li, Qicai; Yang, Xu; Kim, Sun

doi:10.1177/0363546516655333

Cited by 40 publications

(52 citation statements)

References 37 publications

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“…For patients who desired an allograft, the option of a hybrid graft was suggested as an alternative to solely utilizing the allograft. The rationale explained to the patients was that some studies [6][7][8] have demonstrated a higher failure rate with allograft for ACLR. It was discussed that, by combining the autograft with one hamstring tendon of their own, that this possibly, albeit unproven, may increase the rate of the graft healing compared with an allograft alone.…”

Section: Graft Selectionmentioning

confidence: 99%

Clinical Outcomes Following Primary Anterior Cruciate Ligament Reconstruction with Hamstring Autograft versus Planned Hybrid Graft

et al. 2018

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Few studies have compared outcomes between autografts versus hybrid grafts (combination of autograft and allograft) for anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare revision rate and patient-reported outcomes following primary ACLR with a hamstring autograft versus a preoperatively planned hybrid autograft-allograft. At a minimum 2-year follow-up, patients who had undergone primary ACLR with a double-stranded semitendinosus and gracilis hamstring autograft (A) or a planned hybrid (H) graft (single-strand semitendinosus with nonirradiated peroneus longus or tibialis posterior allograft) were contacted to fill out a survey containing the Knee Injury and Osteoarthritis Outcome Score (KOOS), Subjective International Knee Documentation Committee (IKDC) score, Single Assessment Numeric Evaluation (SANE), 12-Item Short-Form Health Survey (SF-12), and visual analog scale (VAS) for activity level prior to injury and at follow-up. From this collection of patients, a matched-pair comparison was made between groups, with patients matched by gender, age at the time of surgery, and follow-up time. Revision rate at follow-up was 8.4 and 2.4% in the A and H groups, respectively ( = 0.073). A total of 148 surveys were completed (83 A, 65 H), from which 36 matched pairs were formed. Within the matched pairs, average age at surgery did not differ significantly between groups (A: 35.7 years, H: 36.0 years, = 0.23). Time to follow-up was 4.3 and 3.7 years in the A and H groups, respectively. Patients with a hybrid graft had significantly higher KOOS Quality of Life subscores (A 69.6, H 79.2, = 0.028), subjective IKDC scores (A 72.6, H 79.7, = 0.031), and SANE scores (A 83.2, H 91.4, = 0.015) at follow-up. Otherwise, no significant differences were found in patient-reported outcome scores between groups. A preoperatively planned hybrid graft, with use of a fresh-frozen, nonirradiated allograft, should be considered as a viable alternative for primary ACLR in older patients.

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Section: Graft Selectionmentioning

confidence: 99%

Clinical Outcomes Following Primary Anterior Cruciate Ligament Reconstruction with Hamstring Autograft versus Planned Hybrid Graft

et al. 2018

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“…Previous studies reported that sterilization with gamma irradiation could result in impaired biomechanical properties [ 38 ]. Thus, recent publications do not advocate irradiated tendon allograft for anterior cruciate ligament reconstruction [ 39 , 40 ]. Sherman et al demonstrated the high load to which PM tendon is exposed [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Pectoralis Major Tear with Retracted Tendon: How to Fill the Gap? Reconstruction with Hamstring Autograft and Fixation with an Interference Screw

Baverel

Messedi

Piétu

et al. 2017

Case Reports in Orthopedics

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Rupture of the pectoralis major tendon is considered an uncommon injury and a significant number of ruptures are missed or diagnosed late, leading to a chronic tear. We report an open reconstruction technique and its outcomes in a case of chronic and retracted PM tear. At the last follow-up (12 months), the patient was pain-free, with a visual analogic scale at 0 all the time. He was very satisfied concerning the cosmetic and clinical results. The constant score was 93%, the SST value 95%, and the Quick DASH score 4.5. MRI performed one year postoperatively confirmed the continuity between PM tendon and graft, even if the aspect of the distal tendon seemed to be thinner than normal PM tendon. The excellent clinical outcomes at one-year follow-up suggest that PM tear with major tendon retraction can be reliably reconstructed with hamstring autograft, using a bioabsorbable screw to optimize the fixation device. This technique has proven its simplicity and efficiency to fill the gap.

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“…For the third surgeon, the option of a planned hybrid graft was suggested as an alternative for patients who initially desired an allograft. The rationale explained to the patients was that some studies [16][17][18] have demonstrated a higher failure rate with allograft for ACLR. It was discussed that, by combining the autograft with one hamstring tendon of their own, this possibly, albeit unproven, may increase the rate of the graft healing compared with an allograft alone.…”

Section: Planned Hybrid Graftmentioning

confidence: 99%

Demographics and Clinical Outcomes of Patients Undergoing Anterior Cruciate Ligament Reconstruction with a Planned or Unplanned Hybrid Graft

et al. 2018

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The purpose of this study was to report the demographics and clinical outcomes of patients at our institution following anterior cruciate ligament reconstruction (ACLR) with a planned or unplanned hybrid autograft–allograft. At a minimum 2-year follow-up, patients at our institution who had undergone primary ACLR with a planned (P) or unplanned (U) hybrid graft using fresh-frozen allografts were contacted to complete a survey containing the Knee Injury and Osteoarthritis Outcome Score, Subjective International Knee Documentation Committee score, Single Assessment Numeric Evaluation, 12-Item Short Form Health Survey, and visual analog scale for activity level. Demographics were compared between groups. Patient-reported outcomes (PROs) and a revision rate were reported for each group. Mean follow-up among all patients was 3.3 years. Revision rate at follow-up was 0.8 and 6.3% in the P and U groups, respectively (p = 0.03). Among patients reached for follow-up (90 P, 30 U), a lower proportion of males was found in the unplanned hybrid graft group (P: 52%, U: 23%, p < 0.01). Unplanned hybrid graft patients were significantly younger at the time of surgery (P: 41.0 years, U: 31.0 years, p < 0.0001). Graft size did not differ between groups (P: 9.1 mm, U: 8.9 mm, p = 0.11). Patients in both groups achieved moderate to high PROs. Demographics differ between patients undergoing ACLR with a planned or unplanned hybrid graft. Patients with a planned hybrid graft are at a significantly reduced risk of postoperative graft failure, likely due to the older age of this group.

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Irradiated Hamstring Tendon Allograft Versus Autograft for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

Abstract: Clinical Trial Register System of The Affiliated Hospital of Qingdao University (qdfy-ky2008-12).

Cited by 40 publications

References 37 publications

Clinical Outcomes Following Primary Anterior Cruciate Ligament Reconstruction with Hamstring Autograft versus Planned Hybrid Graft

Clinical Outcomes Following Primary Anterior Cruciate Ligament Reconstruction with Hamstring Autograft versus Planned Hybrid Graft

Pectoralis Major Tear with Retracted Tendon: How to Fill the Gap? Reconstruction with Hamstring Autograft and Fixation with an Interference Screw

Demographics and Clinical Outcomes of Patients Undergoing Anterior Cruciate Ligament Reconstruction with a Planned or Unplanned Hybrid Graft

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