COMPARISON OF THE CLINICAL RESULTS FROM THE RECONSTRUCTION OF АCL WITH AUTOGRAFT AND ALLOGRAFT TISSUE

Georgian Med News. 2023 Mar:(336):6-12.

Abstract

The ACL is the primary stabilizer of the knee joint. The injury leads to instability of the knee joint, which is a trigger for the subsequent destructive changes of the intra-articular structures such as menisci and cartilage of the joint surfaces. The most affected group is people of an active age, engaged in amateur sports. Also, this pathology is an occupational hazard in the military. In this community, ACL injuries have reached 3.24% in men and 3.51% in women, with increasing trends, especially among women. This data is derived from a study by Keller Army Hospital, West Point, New York. In this study we selected 2 groups of patients - operated with autograft and operated with allograft. The groups included 25 patients followed for a period of 18 months. The tissues used for ACL reconstruction were: 1) for allograft - BTB donor tissue / allograft / 2) for autologous transplantation - mm. Semitendinosus et Gracillis / autograft /. After the operation, the patients are placed in a rehabilitation program in five interconnected phases. The way they are performed allows the principle of gradual loading and constant feedback between the patient and the physiotherapist to be observed. Each of the phases has specific goals in the rehabilitation cycle, which has a certain approximate duration. After completion of the rehabilitation process, the clinical outcomes of both groups were compared using the International Documentation Committee (IKDC), Lysholm, and three in-house diagnostic methods. Our own diagnostic methods are Power test (a strength simulator is used, which directly examines the strength of the limb in flexion and extension in real life test. The results from IKDC were in favor of the autograft group (92.82) and from Lischolm of the allograft group (92.24). In terms of the power test the results were in favor of the allograft group. The result from the Power 1 test clearly shows statistically significant difference in symmetry of power in flexion and extension which is better in the allograft group compared to the autograft group. In our research we did not come across such a test in other studies. In conclusion we proved that the development of a single strict rehabilitation protocol focusing on the principle of gradual increase in workloads achieves comparable results in the frequency of re-rupture in both the allograft and auto-graft groups.

MeSH terms

  • Allografts
  • Autografts
  • Female
  • Humans
  • Knee Joint* / surgery
  • Male
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome