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Nearly 24% failure rate seen in allograft tissue used in ACL reconstructions in the young, active athlete

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ORLANDO — Investigators from Mississippi have found a 23.4% failure rate in bone-patellar tendon-bone allografts when used in primary allograft ACL reconstructions in active patients under the age of 40 years.

Kurre Luber, MD, an orthopedic surgery fellow at Mississippi Sports Medicine and Orthopaedic Center, said "There are more than 100,000 ACL reconstructions performed each year in the United States and over 4,000 articles pertaining to the ACL. Over the past 10 years, ACL reconstruction has become routine with favorable outcomes. However, graft selection is still controversial."

Luber reported his investigation's results at the 2008 American Orthopaedic Society for Sports Medicine's Annual Meeting, here.

Luber and colleagues studied 61 patients who were entered into the center's database who had a primary ACL reconstruction with fresh frozen bone-patellar tendon-bone allograft, and were less than 40 years of age. At a minimum 2 years follow up, 14 (23.4%) were deemed failures.

Patient age ranged from 15 to 39 years with a mean age of 28 years. All ACL reconstruction procedures were performed by one surgeon. Clinical results were assessed by Lachman, Pivot Shift, KT-1000, Arthrometer, Lysholm and Tegner Scores, according to the study abstract.

"Failure was defined as repeat ACL reconstruction due to injury or graft failure," Luber said.

In terms of the Tegner scores, the failure group was a more active population. "They had a higher pre-injury Tegner score ... and a statistically higher Tegner score following surgery," he said.

"In comparison of our previous report of a 2.6% failure rate in patients over 40 years of age, there was a 23.4% failure rate in the under 40 population. Patients should be counseled about this risk," he said.

For more information:

• Luber KT, Greene PY, Barrettt GR. Allograft anterior cruciate ligament reconstruction in the young active patient (Tegner activity leve and failure rate). Presented at the American Orthopaedic Sports Medicine Society 2008 Annual Meeting. July 10-13, 2008. Orlando.