Artikel
Retrospective Analysis on the use of Sterilised Tendon Allografts in Orthopaedic Surgery
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Autoren
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Gudrun Borchert
- German Institute for Cell- and Tissue Replacement, DIZG gGmbH - Non-Profit, Berlin, Germany
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Christin Freutel
- German Institute for Cell- and Tissue Replacement, DIZG gGmbH - Non-Profit, Berlin, Germany
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Norus Ahmed
- German Institute for Cell- and Tissue Replacement, DIZG gGmbH - Non-Profit, Berlin, Germany
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Jan Brune
- German Institute for Cell- and Tissue Replacement, DIZG gGmbH - Non-Profit, Berlin, Germany
| Veröffentlicht: | 26. Oktober 2021 |
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Gliederung
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Objectives: Allografts are used in 78% of revisions and in 42 % of primary ACL surgeries in the USA. Interestingly, this number is much lower in Europe and the type of graft to use still remains a controversial topic. The ''ideal'' graft should fit into the site of interest, provide biomechanical stability and biological tunnel incorporation, as well as facilitate the return of neuromuscular control. Here, we tested whether allografts sterilised using peracetic acid perform similar or better then autografts in regards to revision rates.
Methods: In this retrospective study, surgeons across Germany were contacted for their use of sterilised tendon allografts. A total of 171 completed questionnaires were received. A larger portion of allografts were used in knee (117) and shoulder (48) reconstruction. Tendon allograft use was also reported in ankle reconstruction (2), hip (1) and elbow (3) surgery.
Results and Conclusion: From 171 allografts, 9 suffered re-ruptures with 7 reported as adequate re-trauma's and 2 grafts (1 patient) ruptured due to non-compliance with therapeutic instructions.
Three grafts, used for secondary reconstruction of the pectoralis major displayed partial re-ruptures. A 7,0 % re-rupture rate (including partial ruptures) was observed. The rerepture rate was well within the range reported for both autografts (1.4-15.3%) and allograft (1,6-11%) re-ruptures. No correlation was identified between donor age and an increase in re-rupture rates (p = 0.3635). Additionally, we did not observe any significance in re-ruptures occurring in younger patients. Patients with a BMI < 23 and >39 did not experience a re-rupture, whereas a higher BMI was considered a risk factor with a higher revision rate (ODDS ratio for patients with BMI<28: 0.1954 and p=0.0136). For the graft type, no difference was identified in the re-rupture rate of semitendinosus, gracilis and tibialis. The mean graft size for the re-rupture group was 7.188 ± 1.193 mm (n = 8, range 5.5-9.5 mm) and for the non-rupture group: 7.008 ± 1.093 mm (n = 127, range 5.5-12 mm, p = 0.6792).
Peracetic acid sterilised allografts do not lead to higher re-rupture rates. Furthermore, the re-rupture rate was not affected by donor age or graft size.
