Monday, July 9, 2012

ACL Reconstruction: The 2 Most Important Articles I read Pre-Op

Autograft or Allograft...Apparently, that is the question

This article cites several studies comparing auto/allograft as replacement method for the ACL.
The bonus is it compares those who had their own tissue versus someone else's tissue as the basis for the reconstruction.
Allograft is the use of tissue from someone who is not your genetic identical match.
Autograft is the use of your own tissue for the procedure.
It also follows up at 1 and 2 year intervals for patients who are enrolled in military academies and likely participatory in a variety of high-stress, weight-bearing, pivoting athletic endeavors.
For those of us who are serious, competitive athletes, these are the types of studies that should interest us in selecting an ACL reconstruction method.
Most interestingly for consideration, the difference between your own tissue and someone else's:
"On the other hand, the failure rates were significantly different between autografts and allografts. Cadets who had an ACL reconstruction using an allograft prior to entering the USMA were 6.7 times more likely to suffer a recurrent ACL injury compared to those who had an autograft procedure. Even more remarkable were the one- and two-year findings.
Patellar tendon graft
The patellar tendon autograft (orange arrow) serves as the new ACL in this ACL reconstruction.
One year after entering the USMA, 33% of the cadets who had an allograft ACL before entering had experienced subsequent graft failure, compared with only 2% of those who had an autograft. At the 2-year follow-up point, more than half of those who entered the USMA with an allograft had experienced graft failure compared with only 6% of those who entered with an autograft."

This article outlines the various methods for ACL reconstruction and the benefits/costs and risks associated with each. It is a good outline of the history of various ACL reconstruction.

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