Arthroscopic allogenic ligament transplantation for anterior cruciate ligament reconstruction in 513 cases

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Abstract

OBJECTIVE:

To assess the clinical efficacy of arthroscopic allogenic ligament transplantation for anterior cruciate ligament (ACL) reconstruction.

METHODS:

A total of 513 patients with ACL injury treated with arthroscopic allogenic ACL reconstruction were selected from February 1999 to January 2008. They consisted of 324 males and 189 females, with an average age of 29 years. There were 272 cases of allogenic bone-patellar tendon-bone, 208 cases of allogenic anterior tibialis tendon, 13 cases of allogenic rectus femoris tendon, 8 cases of allogenic flexor tendon, and 12 cases of allogenic achilles tendon-bone. The function of knee joint was assessed by Lysholm knee score and IKDC score before and after transplantation. The stability and the range of motion of knee joint were assessed by Lachman test, pivot shift test, and KT-1000 testing.

RESULTS:

A 12-76 months follow-up was obtained. The Lyshrolm score before transplantation was significantly higher than that after transplantation (P < 0.01). The excellent and good rate of IKDC score was 92% after transplantation. Among the patients, 458 (89.2%) patients were Lachman test negative, and 462 (90%) patients were pivot shift test negative. The anterior shift of tibia after transplantation were significantly shorter than that before transplantation (P < 0.01). Some of the patients suffered from fever, and they were complete recovery after common symptomatic treatment. The rejections appeared in some patients, and they were cured after hormones treatment. Erythrocyte sedimentation rate and C-reactive protein increased in 58 cases for 2-3 days after transplantation, and dropped to normal for 14-30 days. The total activated lymphocytes and the mid-activated lymphocytes were not significantly increased in all patients. The flexor tendon allografts were stretched under arthroscopy in 2 patients. 1 patient was treated with electrothermal shrinkage, and the other patient was treated with ACL revision surgery and ACL LARS-artificial ligament reconstruction. The second operation in other patients showed that the ligaments firmly healed with good tension. Their surfaces covered with synovial membranes, and small vessels grew in them. The active bleeding of the synovial membrane could be seen after little debridement

CONCLUSION:

A middle- and long-term follow-up shows that the arthroscopic allogenic transplantation for ACL reconstruction has the satisfied clinical efficacy with safety.

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