Does irradiation affect the clinical outcome of patellar tendon allograft ACL reconstruction?

Jeffrey A. Rihn, James J. Irrgang, Anikar Chhabra, Freddie H. Fu, Christopher D. Harner

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

The clinical implications of using irradiation to sterilize allograft bone-patellar tendon-bone (BPTB) remains unknown. The purpose of this study was to compare the clinical outcome of anterior cruciate ligament (ACL) reconstruction with irradiated allograft versus autograft BPTB. We hypothesized that patients undergoing ACL reconstruction with irradiated BPTB allograft would have no significant differences in patient-reported and objective parameters compared to those undergoing autograft BPTB reconstruction. Patients who underwent ACL reconstruction with either irradiated allograft or autograft BPTB from 1996 to 2002 were eligible for this study. One hundred and two patients (39 allograft, 63 autograft) met the study criteria and were available for follow-up. The BPTB allografts were obtained from a single tissue bank and were sterilized with 2.5 Mrad of irradiation prior to distribution. Participants completed the International Knee Documentation Committee (IKDC) subjective knee form and returned for physical and radiographic examinations, instrumented measurement of laxity, and functional testing. Patients were evaluated at an average follow-up of 4.2 years (range 1.8-8.4). Those undergoing allograft reconstruction were older (44±8.4 vs. 25.3±9.3 years, p<0.001) and had a longer median time from injury to surgery (17.1 weeks vs. 9.7 weeks, p=0.04). There was no difference in IKDC Subjective Knee Scores between groups (86.7 allograft vs. 88.0 autograft, p=0.65). The average maximum manual KT-1000 side-to-side difference was 1.3 and 2.2 mm for allograft and autograft, respectively (p=0.04); however, after adjusting for age, this difference was no longer significant. 90.6% of the allograft and 82.8% of the autograft had normal/nearly normal overall IKDC physical examination rating (p=0.37). 66.7% of the allograft and 77.8% of the autograft returned to the same or more strenuous level of sports (p=0.25). Patients undergoing ACL reconstruction with irradiated allograft BPTB had similar clinical outcomes compared to those reconstructed with autograft BPTB. These data suggest that irradiation can be used to sterilize BPTB allograft without adversely affecting clinical outcome.

Original languageEnglish (US)
Pages (from-to)885-896
Number of pages12
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume14
Issue number9
DOIs
StatePublished - Sep 2006
Externally publishedYes

Fingerprint

Patellar Ligament
Anterior Cruciate Ligament Reconstruction
Allografts
Bone and Bones
Autografts
Knee
Documentation
Physical Examination
Tissue Banks

Keywords

  • ACL
  • Allograft
  • Autograft
  • Irradiation
  • Patellar tendon

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Does irradiation affect the clinical outcome of patellar tendon allograft ACL reconstruction? / Rihn, Jeffrey A.; Irrgang, James J.; Chhabra, Anikar; Fu, Freddie H.; Harner, Christopher D.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 14, No. 9, 09.2006, p. 885-896.

Research output: Contribution to journalArticle

Rihn, Jeffrey A. ; Irrgang, James J. ; Chhabra, Anikar ; Fu, Freddie H. ; Harner, Christopher D. / Does irradiation affect the clinical outcome of patellar tendon allograft ACL reconstruction?. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2006 ; Vol. 14, No. 9. pp. 885-896.
@article{7986a4b719dd4a0fb3855d4becf0aa6a,
title = "Does irradiation affect the clinical outcome of patellar tendon allograft ACL reconstruction?",
abstract = "The clinical implications of using irradiation to sterilize allograft bone-patellar tendon-bone (BPTB) remains unknown. The purpose of this study was to compare the clinical outcome of anterior cruciate ligament (ACL) reconstruction with irradiated allograft versus autograft BPTB. We hypothesized that patients undergoing ACL reconstruction with irradiated BPTB allograft would have no significant differences in patient-reported and objective parameters compared to those undergoing autograft BPTB reconstruction. Patients who underwent ACL reconstruction with either irradiated allograft or autograft BPTB from 1996 to 2002 were eligible for this study. One hundred and two patients (39 allograft, 63 autograft) met the study criteria and were available for follow-up. The BPTB allografts were obtained from a single tissue bank and were sterilized with 2.5 Mrad of irradiation prior to distribution. Participants completed the International Knee Documentation Committee (IKDC) subjective knee form and returned for physical and radiographic examinations, instrumented measurement of laxity, and functional testing. Patients were evaluated at an average follow-up of 4.2 years (range 1.8-8.4). Those undergoing allograft reconstruction were older (44±8.4 vs. 25.3±9.3 years, p<0.001) and had a longer median time from injury to surgery (17.1 weeks vs. 9.7 weeks, p=0.04). There was no difference in IKDC Subjective Knee Scores between groups (86.7 allograft vs. 88.0 autograft, p=0.65). The average maximum manual KT-1000 side-to-side difference was 1.3 and 2.2 mm for allograft and autograft, respectively (p=0.04); however, after adjusting for age, this difference was no longer significant. 90.6{\%} of the allograft and 82.8{\%} of the autograft had normal/nearly normal overall IKDC physical examination rating (p=0.37). 66.7{\%} of the allograft and 77.8{\%} of the autograft returned to the same or more strenuous level of sports (p=0.25). Patients undergoing ACL reconstruction with irradiated allograft BPTB had similar clinical outcomes compared to those reconstructed with autograft BPTB. These data suggest that irradiation can be used to sterilize BPTB allograft without adversely affecting clinical outcome.",
keywords = "ACL, Allograft, Autograft, Irradiation, Patellar tendon",
author = "Rihn, {Jeffrey A.} and Irrgang, {James J.} and Anikar Chhabra and Fu, {Freddie H.} and Harner, {Christopher D.}",
year = "2006",
month = "9",
doi = "10.1007/s00167-006-0036-7",
language = "English (US)",
volume = "14",
pages = "885--896",
journal = "Knee Surgery, Sports Traumatology, Arthroscopy",
issn = "0942-2056",
publisher = "Springer Verlag",
number = "9",

}

TY - JOUR

T1 - Does irradiation affect the clinical outcome of patellar tendon allograft ACL reconstruction?

AU - Rihn, Jeffrey A.

AU - Irrgang, James J.

AU - Chhabra, Anikar

AU - Fu, Freddie H.

AU - Harner, Christopher D.

PY - 2006/9

Y1 - 2006/9

N2 - The clinical implications of using irradiation to sterilize allograft bone-patellar tendon-bone (BPTB) remains unknown. The purpose of this study was to compare the clinical outcome of anterior cruciate ligament (ACL) reconstruction with irradiated allograft versus autograft BPTB. We hypothesized that patients undergoing ACL reconstruction with irradiated BPTB allograft would have no significant differences in patient-reported and objective parameters compared to those undergoing autograft BPTB reconstruction. Patients who underwent ACL reconstruction with either irradiated allograft or autograft BPTB from 1996 to 2002 were eligible for this study. One hundred and two patients (39 allograft, 63 autograft) met the study criteria and were available for follow-up. The BPTB allografts were obtained from a single tissue bank and were sterilized with 2.5 Mrad of irradiation prior to distribution. Participants completed the International Knee Documentation Committee (IKDC) subjective knee form and returned for physical and radiographic examinations, instrumented measurement of laxity, and functional testing. Patients were evaluated at an average follow-up of 4.2 years (range 1.8-8.4). Those undergoing allograft reconstruction were older (44±8.4 vs. 25.3±9.3 years, p<0.001) and had a longer median time from injury to surgery (17.1 weeks vs. 9.7 weeks, p=0.04). There was no difference in IKDC Subjective Knee Scores between groups (86.7 allograft vs. 88.0 autograft, p=0.65). The average maximum manual KT-1000 side-to-side difference was 1.3 and 2.2 mm for allograft and autograft, respectively (p=0.04); however, after adjusting for age, this difference was no longer significant. 90.6% of the allograft and 82.8% of the autograft had normal/nearly normal overall IKDC physical examination rating (p=0.37). 66.7% of the allograft and 77.8% of the autograft returned to the same or more strenuous level of sports (p=0.25). Patients undergoing ACL reconstruction with irradiated allograft BPTB had similar clinical outcomes compared to those reconstructed with autograft BPTB. These data suggest that irradiation can be used to sterilize BPTB allograft without adversely affecting clinical outcome.

AB - The clinical implications of using irradiation to sterilize allograft bone-patellar tendon-bone (BPTB) remains unknown. The purpose of this study was to compare the clinical outcome of anterior cruciate ligament (ACL) reconstruction with irradiated allograft versus autograft BPTB. We hypothesized that patients undergoing ACL reconstruction with irradiated BPTB allograft would have no significant differences in patient-reported and objective parameters compared to those undergoing autograft BPTB reconstruction. Patients who underwent ACL reconstruction with either irradiated allograft or autograft BPTB from 1996 to 2002 were eligible for this study. One hundred and two patients (39 allograft, 63 autograft) met the study criteria and were available for follow-up. The BPTB allografts were obtained from a single tissue bank and were sterilized with 2.5 Mrad of irradiation prior to distribution. Participants completed the International Knee Documentation Committee (IKDC) subjective knee form and returned for physical and radiographic examinations, instrumented measurement of laxity, and functional testing. Patients were evaluated at an average follow-up of 4.2 years (range 1.8-8.4). Those undergoing allograft reconstruction were older (44±8.4 vs. 25.3±9.3 years, p<0.001) and had a longer median time from injury to surgery (17.1 weeks vs. 9.7 weeks, p=0.04). There was no difference in IKDC Subjective Knee Scores between groups (86.7 allograft vs. 88.0 autograft, p=0.65). The average maximum manual KT-1000 side-to-side difference was 1.3 and 2.2 mm for allograft and autograft, respectively (p=0.04); however, after adjusting for age, this difference was no longer significant. 90.6% of the allograft and 82.8% of the autograft had normal/nearly normal overall IKDC physical examination rating (p=0.37). 66.7% of the allograft and 77.8% of the autograft returned to the same or more strenuous level of sports (p=0.25). Patients undergoing ACL reconstruction with irradiated allograft BPTB had similar clinical outcomes compared to those reconstructed with autograft BPTB. These data suggest that irradiation can be used to sterilize BPTB allograft without adversely affecting clinical outcome.

KW - ACL

KW - Allograft

KW - Autograft

KW - Irradiation

KW - Patellar tendon

UR - http://www.scopus.com/inward/record.url?scp=33750159217&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750159217&partnerID=8YFLogxK

U2 - 10.1007/s00167-006-0036-7

DO - 10.1007/s00167-006-0036-7

M3 - Article

C2 - 16502300

AN - SCOPUS:33750159217

VL - 14

SP - 885

EP - 896

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

IS - 9

ER -