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Title: Failure Rates of Cadaver Replacement Higher in Younger Patients Undergoing ACL Reconstruction
URL: http://www.pslgroup.com/dg/2256F2.htm
Doctor's Guide
July 10, 2008

ORLANDO, Fla -- July 10, 2008 -- The use of cadaver replacement ligaments may not be the best choice for young, athletic patients, according to a study presented at the 2008 Annual Meeting of the American Orthopaedic Society for Sports Medicine.

With an estimated 80,000 anterior cruciate ligament (ACL) tears happening each year in the United States, choosing the best replacement ligament for surgery is only 1 key to success.

"This study found a very high failure rate in patients 40 years and younger with high activity levels in ACL-dependent sports like tennis, basketball, [and] soccer … It would be naïve to think that only the graft selection led to these failures," said coauthor Kurre Luber, MD, Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi.

"We also need to look at surgical technique. Better outcome measures need to be developed. However, this study definitely raises questions about the validity of using cadaver tissue in this patient subgroup."

In the study, 64 patients, aged 40 years or younger with high activity levels and who had ACL reconstruction with a cadaver replacement ligament, were followed for a minimum of 2 years.

ACL reconstruction failure was defined as requiring a second reconstruction due to injury or graft failure, or poor scores on a combination of orthopaedic outcome measure tests.

The study found that 15 (23.4%) of the 64 patients' ACL reconstructions failed as defined by the study.

"This failure rate in this young, active population is exceedingly high when compared to a previous study that looked at failure rates of cadaver replacement ligament in patients older than 40 [years]," said coauthor Gene Barrett, MD, Mississippi Sports Medicine and Orthopaedic Center.

"The older group's failure rate was 2.4%. So while there are obvious benefits of using the cadaver ligament, like avoiding a second surgical site on the patient, a quicker return to work, and less postoperative pain, for a young patient who is very active, it may not be the right choice."


SOURCE: American Orthopaedic Society for Sports Medicine

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