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Journal of Zhejiang University SCIENCE B 2009 Vol.10 No.4 P.306~316

http://doi.org/10.1631/jzus.B0820335


ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft


Author(s):  Kang SUN, Shao-qi TIAN, Ji-hua ZHANG, Chang-suo XIA, Cai-long ZHANG, Teng-bo YU

Affiliation(s):  Department of Orthopaedics; more

Corresponding email(s):   sunkang_qy@yahoo.com.cn, shaoqi99@yahoo.com.cn

Key Words:  Anterior cruciate ligament (ACL) reconstruction, Patellar tendon, Autograft, Allograft, Irradiation, Prospective randomized study


Kang SUN, Shao-qi TIAN, Ji-hua ZHANG, Chang-suo XIA, Cai-long ZHANG, Teng-bo YU. ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft[J]. Journal of Zhejiang University Science B, 2009, 10(4): 306~316.

@article{title="ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft",
author="Kang SUN, Shao-qi TIAN, Ji-hua ZHANG, Chang-suo XIA, Cai-long ZHANG, Teng-bo YU",
journal="Journal of Zhejiang University Science B",
volume="10",
number="4",
pages="306~316",
year="2009",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B0820335"
}

%0 Journal Article
%T ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft
%A Kang SUN
%A Shao-qi TIAN
%A Ji-hua ZHANG
%A Chang-suo XIA
%A Cai-long ZHANG
%A Teng-bo YU
%J Journal of Zhejiang University SCIENCE B
%V 10
%N 4
%P 306~316
%@ 1673-1581
%D 2009
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0820335

TY - JOUR
T1 - ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft
A1 - Kang SUN
A1 - Shao-qi TIAN
A1 - Ji-hua ZHANG
A1 - Chang-suo XIA
A1 - Cai-long ZHANG
A1 - Teng-bo YU
J0 - Journal of Zhejiang University Science B
VL - 10
IS - 4
SP - 306
EP - 316
%@ 1673-1581
Y1 - 2009
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0820335


Abstract: 
Objective: To analyze the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with irradiated bone-patellar tendon-bone (BPTB) allograft compared with non-irradiated allograft and autograft. Methods: All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution. A total of 68 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into one of the two groups (autograft and irradiated allograft groups). The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months of follow-up (ranging from 24 to 47 months), patients were evaluated by the same observer according to objective and subjective clinical evaluations. Results: Of these patients, 65 (autograft 33, irradiated allograft 32) were available for full evaluation. When the irradiated allograft group was compared to the autograft group at the 31-month follow-up by the Lachman test, the anterior drawer test (ADT), the pivot shift test, and KT-2000 arthrometer test, statistically significant differences were found. Most importantly, 87.8% of patients in the autograft group and just only 31.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft (34.4%) was higher than that with autograft (6.1%). The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Documentation Committee (IKDC), functional and subjective evaluations, and activity level testing, no statistically significant differences were found between the two groups. Besides, patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever. When the patients had a fever, the laboratory examinations of all patients were almost normal. Blood routine was normal, the values of erythrocyte sedimentation rate (ESR) were 5~16 mm/h and the contents of C reactive protein (CRP) were 3~10 mg/L. Conclusion: We conclude that the short term clinical outcomes of the ACL reconstruction with irradiated BPTB allograft were adversely affected. The less than satisfactory results led the senior authors to discontinue the use of irradiated BPTB allograft in ACL surgery and not to advocate using the gamma irradiation as a secondary sterilizing method.

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