New Study: Autografts Last Longer for ACL Reconstruction

Anterior cruciate ligament (ACL) injuries occur about 200, 000 times each year and about 100, 000 of those patients undergo reconstructive surgery.

Seventy percent of ACL injuries occur when patients participate in agility sports, mainly basketball, soccer, skiing, and football. ACL injuries are more prevalent in patients 15-45 years old since people in this age group are more likely to maintain an active lifestyle. Women are more likely to suffer an ACL injury although greater numbers of men become injured since men are more likely to participate in sports.

On July 11, 2014, researchers presented the results of a new study regarding the use of autografts for reconstructing ligaments. The data was presented at the American Orthopedic Society of Sports Medicine’s Annual Meeting (AOSSM). Lead author, Dr. Craig R. Bottoni, from Tripler Army Medical Center in Honolulu, revealed that when reconstructing ligaments, allografts fail more frequently than autografts.

Bottoni followed 99 patients who’d had an ACL reconstructed either from an allograft, tissue from a donor, or an autograft, tissue taken from the same individual. Bottoni and his team followed these patients for 10 years and found that 80% of grafts remained intact and stabile.

Although the majority of grafts remained in good condition, patients with an allograft experienced a failure rate that was more than three times higher than those reconstructed with an autograft.

All allografts were from the same tissue bank and processed in the same fashion, the grafts were fixed identically in all knees, and all patients followed the same postoperative recovery procedure.

Since the study only examined a tibialis posterior allograft, the authors cautioned that it would be premature to draw conclusions about other types of allografts. Out of 99 individuals studied, 95 were in active military duty and 87 were male. There were 13 allograft failures and 4 autograft failures in the group that required revision reconstruction. Between the remaining allograft and autograft patients, there was no difference in mean Tegner, SANE, or IKDC scores.