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Comparison of Clinical Outcomes After Anterior Cruciate Ligament Reconstruction Using a Hybrid Graft Versus a Hamstring Autograft.
Arthroscopy. 2018 05; 34(5):1508-1516.A

Abstract

PURPOSE

This study aimed to compare the clinical outcomes of patients who underwent anterior cruciate ligament (ACL) reconstruction with a hybrid graft versus an autograft after 3 years of follow-up.

METHODS

Among 57 patients with an ACL injury who underwent ACL reconstruction, 28 patients received a hybrid graft (gracilis and semitendinosus tendon autograft plus a soft tissue allograft) and 29 patients received an autograft (gracilis and semitendinosus tendon autograft). The 2 groups were compared after a minimum 3-year follow-up regarding International Knee Documentation Committee (IKDC) assessment of knee function and stability, pivot-shift test, Lachman test, and KT-1000 side-to-side differences. The patient-reported Tegner activity score, Lysholm score, and subjective IKDC score were also compared. Graft failures were identified by patient-reported outcomes, physical examinations, or magnetic resonance imaging, and were confirmed on second-look arthroscopy; failure rate was compared between groups.

RESULTS

At final follow-up, the 2 groups significantly differed in pivot-shift test result (P = .013) and Lachman test result (P = .027). The failure rate tended to be greater in the hybrid graft group (14.3%) than in the autograft group (3.4%) (P = .148). All 5 patients with failed graft reconstruction were revised after second-look arthroscopy. The KT-1000 side-to-side differences at final follow-up were significantly inferior in the hybrid graft group (3.5 ± 2.0) compared with the autograft group (2.5 ± 1.0, P = .024). The hybrid graft group also had a lower mean Lysholm score (P = .000) and subjective IKDC score (P = .006) than the autograft group. The mean Tegner activity score was 6.8 ± 0.8 in the hybrid graft group and 6.9 ± 0.6 in the autograft group (P = .436).

CONCLUSIONS

The knee stability and patient-reported scores in the autograft-irradiated allograft hybrid graft ACL reconstruction group were significantly inferior compared with those in the autograft ACL reconstruction group.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, People's Republic of China.Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, People's Republic of China.Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China; Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, People's Republic of China. Electronic address: profyzzhang@126.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29287949

Citation

Wang, Hong-De, et al. "Comparison of Clinical Outcomes After Anterior Cruciate Ligament Reconstruction Using a Hybrid Graft Versus a Hamstring Autograft." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 34, no. 5, 2018, pp. 1508-1516.
Wang HD, Gao SJ, Zhang YZ. Comparison of Clinical Outcomes After Anterior Cruciate Ligament Reconstruction Using a Hybrid Graft Versus a Hamstring Autograft. Arthroscopy. 2018;34(5):1508-1516.
Wang, H. D., Gao, S. J., & Zhang, Y. Z. (2018). Comparison of Clinical Outcomes After Anterior Cruciate Ligament Reconstruction Using a Hybrid Graft Versus a Hamstring Autograft. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 34(5), 1508-1516. https://doi.org/10.1016/j.arthro.2017.11.020
Wang HD, Gao SJ, Zhang YZ. Comparison of Clinical Outcomes After Anterior Cruciate Ligament Reconstruction Using a Hybrid Graft Versus a Hamstring Autograft. Arthroscopy. 2018;34(5):1508-1516. PubMed PMID: 29287949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Clinical Outcomes After Anterior Cruciate Ligament Reconstruction Using a Hybrid Graft Versus a Hamstring Autograft. AU - Wang,Hong-De, AU - Gao,Shi-Jun, AU - Zhang,Ying-Ze, Y1 - 2017/12/26/ PY - 2017/07/19/received PY - 2017/11/09/revised PY - 2017/11/09/accepted PY - 2017/12/31/pubmed PY - 2019/9/10/medline PY - 2017/12/31/entrez SP - 1508 EP - 1516 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 34 IS - 5 N2 - PURPOSE: This study aimed to compare the clinical outcomes of patients who underwent anterior cruciate ligament (ACL) reconstruction with a hybrid graft versus an autograft after 3 years of follow-up. METHODS: Among 57 patients with an ACL injury who underwent ACL reconstruction, 28 patients received a hybrid graft (gracilis and semitendinosus tendon autograft plus a soft tissue allograft) and 29 patients received an autograft (gracilis and semitendinosus tendon autograft). The 2 groups were compared after a minimum 3-year follow-up regarding International Knee Documentation Committee (IKDC) assessment of knee function and stability, pivot-shift test, Lachman test, and KT-1000 side-to-side differences. The patient-reported Tegner activity score, Lysholm score, and subjective IKDC score were also compared. Graft failures were identified by patient-reported outcomes, physical examinations, or magnetic resonance imaging, and were confirmed on second-look arthroscopy; failure rate was compared between groups. RESULTS: At final follow-up, the 2 groups significantly differed in pivot-shift test result (P = .013) and Lachman test result (P = .027). The failure rate tended to be greater in the hybrid graft group (14.3%) than in the autograft group (3.4%) (P = .148). All 5 patients with failed graft reconstruction were revised after second-look arthroscopy. The KT-1000 side-to-side differences at final follow-up were significantly inferior in the hybrid graft group (3.5 ± 2.0) compared with the autograft group (2.5 ± 1.0, P = .024). The hybrid graft group also had a lower mean Lysholm score (P = .000) and subjective IKDC score (P = .006) than the autograft group. The mean Tegner activity score was 6.8 ± 0.8 in the hybrid graft group and 6.9 ± 0.6 in the autograft group (P = .436). CONCLUSIONS: The knee stability and patient-reported scores in the autograft-irradiated allograft hybrid graft ACL reconstruction group were significantly inferior compared with those in the autograft ACL reconstruction group. LEVEL OF EVIDENCE: Level III, retrospective comparative study. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/29287949/Comparison_of_Clinical_Outcomes_After_Anterior_Cruciate_Ligament_Reconstruction_Using_a_Hybrid_Graft_Versus_a_Hamstring_Autograft_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(17)31439-1 DB - PRIME DP - Unbound Medicine ER -