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 central one-third bone-patellar tendon-bone reconstruction of the anterior cruciate ligament (ACL), 2 groups of 30 patients were evaluated subjectively and 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 rehabilitation was employed and follow-up visits at 3, 6, 12, 24, and 60 months noted swelling, pain, range of motion, and patellofemoral crepitus, and Lachman test, pivot shift test, and side-to-side arthrometer differences. Results: Results were analyzed using 2-sample t test and chi -square analysis. Average 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, giving way, effusion, Lachman and pivot shift results, or arthrometer measurements. Two patients, 1 allograft and 1 autograft had complete rupture of their 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 ruptured 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 autografts) but was present at 2 years and did not change at 5 years. A trend toward 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.