Abstract
PurposeThe purpose of this study is to investigate the clinical outcome for patients after knee ligament reconstructions with allografts at a university hospital.MethodsA total of 33 patients received allografts for reconstructive knee surgery between 2007 and 2017. The follow up evaluation consisted of a clinical knee examination including evaluation of range of motion (ROM), lateral and medial laxity, the Lachman test, the Pivot shift test, the sag test, the posterior drawer test and checking for patellofemoral pain. The following patient-reported outcome measures (PROMs) were used; the Lysholm Function Score, the Tegner activity score, and the Knee injury and Osteoarthritis Outcome Score (KOOS).ResultsTwenty-one (64%) patients were available for the follow-up evaluation and the mean follow-up time was 4.8 years. A total of 16 out of 21 patients had multiligament injuries of which the ACL was the ligament most frequently ruptured. At the time of follow-up, 14 out of 16 patients (87%) with ACL injury had Lachman test grade 0 or grade 1 + , and 12 out of 13 (92%) had a pivot shift grade 0 or 1 + . The mean Lysholm Score was 74. All mean KOOS subscale values were ≥ 59 at the follow-up. The preoperative Tegner activity score was 3 (range, 1–6) and 4 (range, 2–6) at follow up. There were no deep postoperative infections. A total of 19 out of 21 patients (90%) reported that they would have undergone surgery again had they known the clinical outcome in advance.ConclusionsThe patients improved from the preoperative score to the follow-up score in the knee-related Quality of Life (QoL) KOOS subscale. None of the patients were diagnosed with deep postoperative infections.
Highlights
A multiligament injury of the knee is a serious injury which historically had variable prognosis, depending on the severity and management of the injury [15]
Current literature summarizes that surgically treated patients have far better outcomes compared to non-operative management [7, 10, 32], and that repair has a higher failure rate compared to reconstruction, especially regarding repair of the posterolateral corner [22]
The aim of the present study was to evaluate the outcomes for patients who had knee ligament reconstruction with an allograft at our hospital
Summary
A multiligament injury of the knee is a serious injury which historically had variable prognosis, depending on the severity and management of the injury [15]. Current literature summarizes that surgically treated patients have far better outcomes compared to non-operative management [7, 10, 32], and that repair has a higher failure rate compared to reconstruction, especially regarding repair of the posterolateral corner [22]. Potential challenges of allografts include difficulties with strength, availability, and cost. Additional challenges to consider with the use of allografts are transportation time of the grafts and costs, which may influence the choice of grafts and where to purchase them. Religious and legislative concerns may influence the use of allografts. This includes variations in price from different suppliers, which in turn are influenced by the legislation of the current country
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