Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction: A 5-year follow-up

Purpose: To compare the long-term results of allograft versus autograft cen tral one-third bone-patellar tendon-bone reconstruction of the anterior cru ciate ligament (ACL), 2 groups of 30 patients were evaluated subjectively a nd objectively at an average follow-up of 63 months (range, 55 to 78 months ). Type of Study: A prospective nonrandomized study. Methods: All surgeries were performed endoscopically by a single surgeon using metal interference screw fixation between May 1991 and November 1992. Early aggressive rehabi litation was employed and follow-up visits at 3, 6, 12, 24, and 60 months n oted swelling, pain, range of motion, and patellofemoral crepitus, and Lach man test, pivot shift test, and side-to-side arthrometer differences. Resul ts: Results were analyzed using 2-sample t test and chi -square analysis. A verage age at surgery for autografts was 25 years (range, 14 to 49) and for allografts was 28 years (range, 14 to 53). The presence of meniscal tears were similar (allografts, 23 tears; autografts, 19 tears). At follow-up, no statistically significant difference was found for the presence of pain, g iving way, effusion, Lachman and pivot shift results, or arthrometer measur ements. Two patients, 1 allograft and 1 autograft had complete rupture of t heir grafts. There was no late stretching out of either graft and patients stable at 2 years were stable at 5 years, with the exception of the 1 ruptu red graft in each group. Conclusions: A trend toward a greater incidence of glide on pivot testing was seen in the allografts (4 allografts v 2 autogr afts) but was present at 2 years and did not change at 5 years. A trend tow ard greater loss of extension in autografts (2.47 degrees) than allografts (1.07 degrees) was seen at 5-year follow-up, not seen at 2 years.