Arthroscopic anatomic double-bundle ACL reconstruction using irradiated versus non-irradiated hamstring tendon...

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Anterior cruciate ligament (ACL) tears are common injuries requiring surgical reconstruction.
• Hamstring allografts are frequently used, but their processing (e.g., irradiation) may affect outcomes.
• Evaluating the impact of graft processing on clinical results is crucial for optimizing ACL reconstruction.

Purpose of the Study:

• To compare the clinical outcomes of anatomic double-bundle ACL reconstruction using irradiated versus non-irradiated hamstring allografts.
• To assess differences in graft laxity, stability, and functional recovery between the two allograft types.

Main Methods:

• Prospective randomized study of 112 patients undergoing double-bundle ACL reconstruction.
• Patients were assigned to either irradiated (Ir-Allo) or non-irradiated (Non-ir-Allo) hamstring tendon allograft groups.
• Clinical evaluations, including Lachman, ADT, pivot shift tests, KT-2000 arthrometer, and IKDC scores, were performed pre- and post-operatively.

Main Results:

• Eighty-three patients completed the mean 5.7-year follow-up.
• The irradiated allograft group showed significantly increased anterior and rotational laxity (P < 0.05) and higher rates of arthritic progression (30.8% vs 11.4%, P < 0.05).
• No significant differences were observed in functional, subjective, or activity level scores between the groups.

Conclusions:

• Irradiated hamstring allografts lead to increased knee laxity and accelerated arthritic changes after ACL reconstruction.
• Despite similar functional scores, the detrimental effects on joint stability and progression of arthritis warrant caution.
• The use of irradiated hamstring tendon allografts for ACL reconstruction is not recommended.