Effect of Donor Age on Patellar Tendon Allograft Anterior Cruciate Ligament Reconstruction (SS-64)

Abstract

Introduction ACL reconstruction with patellar tendon allograft tissue is a common orthopaedic procedure. It is unknown what effect, if any, the age of the donor has on clinical outcomes. It has been postulated that increasing the donor age would have negative effects on outcome. Biomechanical studies have shown strength of cadaveric patellar tendon to be independent of age, but no clinical studies have evaluated patient outcomes related to this variable. Methods Case logs were reviewed to identify primary ACL reconstruction with allograft patellar tendon by a single surgeon using a standard endoscopic transtibial technique with interference screw fixation. Revision and multi-ligamentous surgeries were excluded. 83 patients were identified meeting this criteria. Allografts were fresh frozen, aseptically harvested patellar tendons from a single tissue bank. The age of the donor was obtained from the tissue bank. Clinical outcomes were obtained by contacting patients by telephone and retrospective chart review. Pre- and postoperative Lysholm scores as well as activity levels were utilized for comparison. Results Data from 75 patients was obtained with an average follow-up of 24 months. The average donor age was 44 years with a range of 14-65 and the average age of the patient was 37 years. Statistical analysis of pre and postoperative Lysholm scores demonstrated improvement that was statistically significant (p<0.001). Using donor age as a continuous variable, there was no effect on either postoperative Lysholm score (p=0.5) or the postoperative Tegner score (p=0.6). Conclusion ACL reconstruction with patellar tendon allograft has a high success rate that is independent of the age of donor tissue utilized for reconstruction with standard technique. ACL reconstruction with patellar tendon allograft tissue is a common orthopaedic procedure. It is unknown what effect, if any, the age of the donor has on clinical outcomes. It has been postulated that increasing the donor age would have negative effects on outcome. Biomechanical studies have shown strength of cadaveric patellar tendon to be independent of age, but no clinical studies have evaluated patient outcomes related to this variable. Case logs were reviewed to identify primary ACL reconstruction with allograft patellar tendon by a single surgeon using a standard endoscopic transtibial technique with interference screw fixation. Revision and multi-ligamentous surgeries were excluded. 83 patients were identified meeting this criteria. Allografts were fresh frozen, aseptically harvested patellar tendons from a single tissue bank. The age of the donor was obtained from the tissue bank. Clinical outcomes were obtained by contacting patients by telephone and retrospective chart review. Pre- and postoperative Lysholm scores as well as activity levels were utilized for comparison. Data from 75 patients was obtained with an average follow-up of 24 months. The average donor age was 44 years with a range of 14-65 and the average age of the patient was 37 years. Statistical analysis of pre and postoperative Lysholm scores demonstrated improvement that was statistically significant (p<0.001). Using donor age as a continuous variable, there was no effect on either postoperative Lysholm score (p=0.5) or the postoperative Tegner score (p=0.6). ACL reconstruction with patellar tendon allograft has a high success rate that is independent of the age of donor tissue utilized for reconstruction with standard technique.