Better 4-year outcomes for anterior cruciate ligament reconstruction with double-layer versus single-layer bone-patellar tendon-bone allografts

Knee Surg Sports Traumatol Arthrosc. 2017 May;25(5):1443-1448. doi: 10.1007/s00167-015-3936-6. Epub 2015 Dec 24.

Abstract

Purpose: To evaluate the results of anterior cruciate ligament reconstruction using a double-layer bone-patellar tendon-bone (DBPTB) graft.

Methods: Between 2010 and 2011, 98 patients underwent anterior cruciate ligament reconstruction with an allograft. Forty-seven of these patients received a DBPTB allograft and 51 received a traditional monolayer BPTB graft. Outcomes were evaluated at the end of a minimum 4-year follow-up in both groups using KT 1000 arthrometer measurements, Lachman and pivot-shift tests, the International Knee Documentation Committee form, and Lysholm scores.

Results: One patient (1/47, 2 %) in the DBPTB allograft group and six patients (6/51, 12 %) in the traditional monolayer BPTB graft were lost during follow-up because of graft rupture (n.s.). The mean side-to-side differences in the DBPTB and monolayer BPTB graft groups 4 years post-operatively were significantly different at 1.4 ± 1.3 and 1.7 ± 1.6 mm, respectively (p < 0.05). The DBPTB group performed significantly better than the BPTB group on the Lachman test, International Knee Documentation Committee knee score, and Lysholm scores (p < 0.05).

Conclusions: The DBPTB allograft group achieved better outcomes than the traditional BPTB allograft group regarding success rate, anterior stability, and knee function.

Level of evidence: Level II.

Keywords: Allograft; Anterior cruciate ligament reconstruction; Bone-patellar tendon-bone; Double-layer.

MeSH terms

  • Adult
  • Allografts
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction / methods
  • Anterior Cruciate Ligament Reconstruction / rehabilitation*
  • Bone-Patellar Tendon-Bone Grafting / methods*
  • Bone-Patellar Tendon-Bone Grafts
  • Female
  • Humans
  • Knee Joint / surgery*
  • Male
  • Prospective Studies
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult