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Whats New In Sports Medicine

Posted May 20 2010 4:22am

The most commonly used grafts are bone-patellar tendon-bone and hamstring autografts. The

improvements in fixation devices for soft-tissue grafts have popularized the use of hamstring

autografts in recent years; many surgeons base their graft selection on minimizing harvest-site

complications.

Anterior Cruciate Ligament Substitutes … Under 40 go for Hamstrings Over Allograft BTB

The most commonly used grafts are bone-patellar tendon-bone and hamstring autografts.

The improvements in fixation devices for soft-tissue grafts have popularized the use of

hamstring autografts in recent years; many surgeons base their graft selection on minimizing

harvest-site complications. There are substantial complications in association with the use of

bone-patellar tendon-bone autograft, including anterior knee pain, pain with kneeling, loss of

extension, and poorer recovery of quadriceps strength.

The use of hamstring autograft avoids these complications but has been reported to result in

weakness of knee flexion and internal rotation, which may be crucial for certain athletes who

rely on these important hamstring functions for optimum performance.

Sensory deficits resulting from injury to branches of the saphenous nerve during hamstring

harvest have been reported. It has been well documented that the hamstring tendons

regenerate, but the function of regenerated tendons has been called into question as the

tendon often heals in a non-anatomic position. Tiger Woods had a hamstring graft substitute

in 2009

A New study , presented at the American Orthopaedic Society for Sports Medicine 2008

Annual Meeting, found that because of the almost 24% failure rate, the use of cadaver

replacement ligaments might not be the best choice for young athletic patients. The older

group’s failure rate was 2.4%. So although there are obvious benefits to using the cadaver

ligament, such as avoiding a second surgical site on the patient, a quicker return to work,

and less postoperative pain, for a young patient who is very active, it may not be the right

choice.

A article in Arthroscopy in 2009″ compared, 156 (76 in the autograft group and 80 in the

allograft group) were available for full evaluation. Evaluations included a detailed history,

physical examination, functional knee ligament testing, KT-2000 arthrometer testing

(MEDmetric, San Diego, CA), The mean follow-up was 5.6 years for both groups.

There were no statistically significant differences according to evaluations of outcome

between the 2 groups except that patients in the allograft group had a shorter operation time

and longer fever time postoperatively compared with the autograft group.

The postoperative infection rates were 0% and 1.25% for the autograft group and allograft

group, respectively. There was a significant difference (P < .05) in the development of

osteoarthritis between the operated knee in comparison to the contralateral knee according

to radiographs.However, no significant difference was found between the 2 groups at the

final follow-up examination . CONCLUSIONS: Both groups of patients achieved almost the

same satisfactory outcomes after a mean of 5.6 years of follow-up. Allograft is a reasonable

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