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Xenograft for anterior cruciate ligament reconstruction was associated with high graft processing infection.
- Source :
- Journal of Experimental Orthopaedics; 10/7/2020, Vol. 7 Issue 1, pN.PAG-N.PAG, 1p
- Publication Year :
- 2020
-
Abstract
- Purpose: To evaluate clinical ad radiological outcomes of anterior cruciate ligament (ACL) reconstruction with an immunochemically modified porcine patellar tendon xenograft controlled against human Achilles tendon allograft at 24-month minimum follow-up. Methods: 66 patients undergoing arthroscopic ACL reconstruction were randomized into 2 groups: 34 allografts and 32 xenografts treated to attenuate the host immune response. Follow-up was 24-month minimum. Anterior knee stability was measured as KT − 1000 side-to-side laxity difference (respect to the contralateral healthy knee). Functional performance was assessed by one-legged hop test. Objective manual pivot-shift test and subjective (IKDC, Tegner and SF-36) outcomes were collected. MRI and standard X-Ray were performed. Results: 61 subjects (32 allograft, 29 xenograft) were evaluated at 12 and 24 months. Six of the subjects in xenograft group (20.6%) got an infection attributed to a water-based pathogen graft contamination in processing. Intention-to-treat analysis (using the last observation carried forward imputation method) revealed higher KT − 1000 laxity in xenograft group at 24-month follow-up (P =.042). Also pivot-shift was higher in xenograft group at 12-month (P =.015) and 24-month follow-up (P =.038). Per-protocol analysis (missing/contaminated subjects excluded) did not revealed clinical differences between groups. Tibial tunnel widening in the allograft group was low, whereas xenograft tunnel widening was within the expected range of 20–35% as reported in the literature. No immunological reactivity was associated to xenograft group. Conclusions: High infection rate (20.6%) was reported in xenograft group. Both groups of patients achieved comparable clinical outcomes if missing/contaminated subjects are excluded. Improved harvesting/processing treatments in future studies using xenografts for ACL reconstruction are needed to reduce infection rate, otherwise xenograft should not be used in ACL reconstruction. Level of evidence: Multicenter and double-blinded Randomized Controlled Clinical Trial, Level I. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 21971153
- Volume :
- 7
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of Experimental Orthopaedics
- Publication Type :
- Academic Journal
- Accession number :
- 146321216
- Full Text :
- https://doi.org/10.1186/s40634-020-00292-0