Anterior cruciate ligament reconstruction using cryopreserved allografts

Primary ACL reconstruction historically has been done using autograft tissues whereas allografts have been limited to revision cases and patients who are older or with lower physical demands because some animal studies suggested a slower biologic incorporation rate. The purpose of the current study was to evaluate the effectiveness of the cryopreserved Achilles tendon allograft in primary ACL reconstruction in a consecutive series of athletes. Fifty consecutive patients with a strenuous or moderate preinjury activity level, as defined by the International Knee Documentation Committee (IKDC), had ACL reconstruction using cryopreserved Achilles tendon allografts secured with bioabsorbable interference screws. Five patients were professional athletes. The average age of the patients was 36 years (range, 17-50 years). A 3- to 5-year followup study was done in all of the patients using the IKDC form. Tunnel widening was measured in the lateral radiographs at the widest level. The overall outcome was normal or nearly normal in 94% of the patients. No failures were reported in this series. Forty-six patients (92%) returned to their same preinjury sport activity level. The average KT-1000 side-to-side difference was 2.3 mm. Average tibial tunnel widening was 2.7 mm (range, 0-6 mm); no significant correlation was observed between increased tunnel size and a fair or poor clinical outcome. This experience shows that favorable results can be obtained with cryopreserved Achilles tendon allografts in athletes in whom avoiding donor site morbidity may be an issue in terms of a prompt return to sport.