CLINICAL COMPARISON OF FREEZE-DRIED AND FRESH-FROZEN PATELLAR TENDON ALLOGRAFTS FOR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION OF THE KNEE

被引：49

作者：

INDELICATO, PA

BITTAR, ES

PREVOT, TJ

WOODS, GA

BRANCH, TP

HUEGEL, M

机构：

[1] Department of Orthopaedics, College of Medicine, University of Florida, Gainesville, Florida

来源：

AMERICAN JOURNAL OF SPORTS MEDICINE | 1990年 / 18卷 / 04期

关键词：

D O I：

10.1177/036354659001800401

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

The aim of this study was to evaluate the clinical outcome of freeze-dried compared to fresh frozen al lograft tissue used as a substitute for a ruptured ACL of the knee. In addition, the incidence of any graft rejection phenomena was recorded. Forty-one patients with ACL deficient knees underwent reconstructive sur gery using a patellar bone-tendon-bone allograft that had been freeze-dried (Group 1, N = 14) or fresh frozen (Group 2, N = 27). All patients underwent the same implant technique and rehabilitation program. Followup ranged from 24 to 36 months. The evaluation consisted of subjective, objective, and instrumented laxity testing (KT-1000, MEDmetric, San Diego, CA; and Genucom, FARO Medical Technologies, Inc., Montreal, Canada). There were 31 males and 10 females. Eleven (79%) patients in Group 1 thought their knee was “normal” or “improved,” and 25 (93%) in Group 2 thought the same. In addition, 10 (71%) patients in Group 1 denied any “giving way,” compared to 26 (96%) in Group 2. The mean Lysholm knee score in Group 1 was 86/100 (range, 22 to 100) compared to 92/100 (range, 59 to 100). Clinical examination included the Lachman test and tests for anterior drawer sign and pivot shift. Postop eratively, Group 1 patients had the following results: Lachman test—seven Grade 0, six Grade 1, one Grade 2; anterior drawer sign—eight Grade 0, five Grade 1, one Grade 2; and pivot shift—seven Grade 0, five “trace,” and two “present.” In Group 2, the results showed the following: Lachman test—17 Grade 0, 10 Grade 1; anterior drawer sign, 20 Grade 0, 7 Grade 1; and pivot shift—23 Grade 0, 4 “trace.” The KT-1000 mean left-right difference in Group 1 was 1.2 mm (0.0 to 4.0 mm) compared to 0.9 mm (0.0 to 3.0 mm) for Group 2. The Genucom mean left-right difference in Group 1 was 1.30 mm (0.0 to 3.0 mm) compared to 1.5 mm (0.0 to 9.0 mm) for Group 2. Overall, there was a marked improvement in both groups relative to overall subjective and objective re sults, the fresh frozen recipients doing slightly better than those who received a freeze-dried allograft. Statis tical analysis revealed a significant difference in only 3 of the 21 parameters evaluated. There was no clinical evidence of rejection phenomena in either group. © 1990, SAGE Publications. All rights reserved.

引用

页码：335 / 342

页数：8

共 23 条

[1]

Arnoczky S.P., Warren R.F., Ashlock M.A., Replacement of the anterior cruciate ligament using a patellar tendon allograft An experimental study, J Bone Joint Surg, 68A, pp. 376-385, (1986)

[2]

Bonamo J.J., Krinick R.M., Sporn A.A., Rupture of the patellar ligament after use of its central third for anterior cruciate reconstruction A report of two cases, J Bone Joint Surg, 66A, pp. 1294-1297, (1984)

[3]

Cho K.O., Reconstruction of the anterior cruciate ligament by semitendinosus tenodesis, J Bone Joint Surg, 57A, pp. 608-612, (1975)

[4]

Clancy W.G., Nelson D.A., Reider B., Et al., Antenor cruciate ligament reconstruction using one-third of the patellar ligament, augmented by extra-articular tendon transfers, J Bone Joint Surg, 64A, pp. 352-359, (1982)

[5]

Cordrey L.J., McCorkle H., Hilton M., A comparative study of fresh autogenous and preserved homogenous tendon grafts in rabbits, J Bone Joint Surg, 45B, pp. 182-195, (1963)

[6]

Curtis R.J., DeLee J.C., Drez D.J., Reconstruction of the anterior cruciate ligament with freeze dried fascia lata allografts in dogs, A preliminary report Am J Sports Med, 13, pp. 408-414, (1985)

[7]

Fned J.A., Bergfeld J.A., Weiker G., Et al., Antenor cruciate reconstruction using the Jones-Ellison procedure, J Bone Joint Surg, 67A, pp. 1029-1033, (1985)

[8]

Friedlander G.E., Strong D.M., Sell K.W., Studies on the antigenicity of bone I Freeze-dned and deep-frozen bone allografts in rabbits, J Bone Joint Surg, 58A, pp. 854-858, (1976)

[9]

Insall J., Joseph D.M., Aglietti P., Et al., Bone-block iliotibial-band transfer for anterior cruciate insufficiency, J Bone Joint Surg, 63A, pp. 560-569, (1981)

[10]

Jackson D.W., Grood E.S., Arnoczky S.P., Et al., Freeze dried anterior cruciate ligament allografts Preliminary studies in a goat model, Am J Sports Med, 15, pp. 295-303, (1987)

← 1 2 3 →