Reconstruction of the anterior cruciate ligament with freeze dried fascia lata allografts in dogs

Curtis, Ralph J.; DeLee, Jesse C.; Drez, David

doi:10.1177/036354658501300608

Cited by 134 publications

(59 citation statements)

References 24 publications

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“…A detailed look at individual parameters will shed some light on these possibilities. Similar to all other models (7,16,27,29), allograft complexes were structurally weaker than contralaterals at all intervals studied. Like allografted fascia lata (7), these results show that complexes got weaker during the first 12 weeks after transplantation.…”

Section: Allograft Behaviorsupporting

confidence: 76%

Transplantation of the rabbit medial collateral ligament. II. Biomechanical evaluation of frozen/thawed allografts

Sabiston

Frank

Lam

et al. 1990

Journal Orthopaedic Research

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Summary: This study was designed to test the mechanical behavior of a frozed thawed bone-medial collateral ligament (MCL)-bone allograft in a rabbit model and to compare allograft behavior with contralateral unoperated ligaments as well as a group of normal bone-ligament-bone preparations prior to freezing. Twenty-five mature rabbits received similarly frozen boneMCGbone allografts and were subsequently allowed to heal without immobilization in groups of five for 3, 6, 12, 24, or 48 weeks after transplantation. A series of biomechanical tests was performed on each allograft, contralateral, and external normal control ligament. Results demonstrated that allografts were significantly tighter than controls at 3 weeks and they remained tight over time. All allografts, however, had inferior structural and material behaviors as compared with controls. Allograft insertional bone and substance deteriorated to about 60% of contralateral strength at 12 and 48 weeks. Bony insertions became the most common site of graft weakness. Both stress at failure and the elastic modulus of allograft substance similarly reached a plateau at those intervals, but at about 30% of contralateral controls. Cyclic and load relaxation properties of allografts, on the other hand, did not deteriorate and were, in fact, indistinguishable from contralateral and normal values at 48 weeks. Comparison with a series of fresh autografts suggests that, with the exception of this viscoelastic recovery, allografts were mechanically inferior to autografts in their healing at the intervals tested. Collectively, these results suggest that allograft MCL healing in this composite model is dynamic but slow, featuring changes in bone and soft tissue over the first year after transplantation. Although "viable" and vascular, allografts have not normalized mechanically and, in fact, appear to have reached a new equilibrium whereby properties are neither improving nor deteriorating. Despite this apparent equilibrium, the trend for some viscoelastic recovery provides hope that allografts may have further potential for improvement. Longer-term studies of MCL allograft mechanical behaviors are clearly required.

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Section: Allograft Behaviorsupporting

confidence: 76%

Transplantation of the rabbit medial collateral ligament. II. Biomechanical evaluation of frozen/thawed allografts

Sabiston

Frank

Lam

et al. 1990

Journal Orthopaedic Research

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“…Laboratory studies have described the results of allogenic tissue used for intraarticular ACL reconstruction. 1,4,5,7,9,[12][13][14][15][16][17][18]20 In 1986, Shino et al16 described the results of intraarticular allogenic ACL substitutes using various types of freshfrozen tissue (Achilles tendon, anterior tibialis tendon, peroneal tendons) in the human. Two-thirds of these patients also underwent an extraarticular procedure.…”

mentioning

confidence: 99%

The results of fresh-frozen patellar tendon allografts for chronic anterior cruciate ligament deficiency of the knee

1992

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This prospective study was done to evaluate the clinical outcome of fresh-frozen patellar bone-tendon-bone allograft tissue used as a substitute for chronic insufficiency of the anterior cruciate ligament. Forty-one patients were followed at a mean of 27 months after surgery. The mean time from injury to reconstruction was 34 months. The same operative procedure and postoperative rehabilitation was performed on each patient. The evaluation method consisted of subjective, objective, and instrumented laxity testing. Thirty-seven patients (90%) thought their knee was normal or improved after surgery and had no further episodes of giving way. The combined modified Hughston Knee Score revealed 30 patients (73%) with an excellent or good result and 9 patients (22%) with a fair or poor result. The mean postoperative Lysholm Knee Score was 91 (range, 56 to 100). Thirty-two had a negative pivot shift (78%). The postoperative KT-1000 arthrometer revealed 37 patients had an injured-to-uninjured difference of 5 mm or less (mean, 1.32 mm; range, 0 to 5). There were three traumatic failures at 24 months postoperatively in this group. There was no rejection phenomenon noted postoperatively. In addition, clinical observation showed less postoperative morbidity when compared to a matched autogenous patellar tendon control group.

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“…Freezing, and to a lesser extent freeze-drying, of fresh sterile allografts does not alter the mechanical properties of the implant [6,8,10], whereas irradiation and gamma irradiation decrease the graft's strength, and sterilisation with ethylene oxide produces acute and chronic synovial reaction [5,9,11]. In our patients, there has been no clinical evidence showing any kind of immunological reaction.…”

Section: Discussionmentioning

confidence: 66%

Anterior cruciate ligament reconstruction with fresh-frozen patellar tendon allografts

Valentí¹,

Sala²,

Schweitzer³

1994

International Orthopaedics

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SUMMARYA prospective study was performed on 30 patients who underwent an anterior cruciate ligament reconstruction with fresh-frozen patellar tendon allograft. An arthroscopic technique alone was used in 10 patients, and in the other 20 patients this was combined with a miniarthrotomy. After a mean follow up of 35 months, the overall functional results were satisfactory in 85%. There were no cases of infection, disease transmission or tissue rejection. Fresh-frozen patellar tendon allografts are a good method of anterior cruciate reconstruction. RÉSUMÉOn a réalisé une étude prospective sur 30 patients traités, de 1988 à 1991, par reconstruction du ligament croisé antérieur (LCA) à l'aide d'allogreffes congelées fraîches de tendon rotulien (os-tendon-os). L'intervention, avec forage d'un tunnel fémoral et tibial, a été pratiquée sous simple arthroscopie dans 10 cas, tandis que chez les 20 autres patients elle a été associée a une mini-arthrotomie. Les opérés ont été suivis 35 mois en moyenne, avec un résultat fonctionnel global satisfaisant dans 85% des cas. Pour cette évaluation on a utilisé la cotation ARPEGE. On n'a observé aucun cas d'infection, de transmission de maladie ou de rejet immunologique. En conséquence nous pensons que les allogreffes congelées fraîches de tendon rotulien représentent une alternative valable dans le traitement des lésions du LCA.

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Reconstruction of the anterior cruciate ligament with freeze dried fascia lata allografts in dogs

Cited by 134 publications

References 24 publications

Transplantation of the rabbit medial collateral ligament. II. Biomechanical evaluation of frozen/thawed allografts

Transplantation of the rabbit medial collateral ligament. II. Biomechanical evaluation of frozen/thawed allografts

The results of fresh-frozen patellar tendon allografts for chronic anterior cruciate ligament deficiency of the knee

Anterior cruciate ligament reconstruction with fresh-frozen patellar tendon allografts

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