www.ncbi.nlm.nih.gov/pubmed/19684294
ACL tear is a common condition suffered by those participating in sports involving cutting and pivoting. ACL reconstruction is usually chosen as a firstline treatment for those willing to continue their sports activity. Graft failure after ACL reconstruction is an uncommon event. Recent systematic review of ACL reconstructions with autografts revealed a graft failure rate of 3.6%. Grafts may fail secondary to trauma, poor surgical technique, undiagnosed concurrent knee injuries, and failed biologic incorporation of the graft. It is suggested that two of the most important modifiable risk factors affecting ACL graft failure are activity level after ACL reconstruction and graft type. Nevertheless, risk factors for ACL graft failures are not well studied. Therefore, the objective of this study was to evaluate activity level after ACL reconstruction and graft type as risk factors for ACL graft failure.
Twenty-one patients with ACL graft failure were identified over a 2-year period. Forty-two age- and sex-matched controls were identified over the same period. Results have shown that those with a higher activity level had 5.53 greater odds of ACL graft failure than did those with a lower activity level at the time of graft failure. Furthermore, those with an allograft had 5.56 greater odds of ACL graft failure than did those with an autograft. From the data authors gathered, it can be concluded that allograft patients, compared to autograft patients, may have felt significantly better in the early months after surgery and may have been more likely to try to return to high-level activities earlier in the postoperative period, which would thus put them at a possible increased risk for graft failure. Moreover, some data suggests that allografts, compared to autografts, have delayed remodeling and decreased long-term stability and mechanical function. Possible explanation why those returning to higher activity levels had increased risk of graft failure might be simply because those who do not return to sports activity will not put their knees at increased risk of trauma therefore will not sustain injury again.
Do you have any experiences with patients
treated with allografts? Do you find any differences in rehab between allograft
and autograft patients eg. pain, ROM, return to activity.?
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