Post on 16-Dec-2015
A LITERATURE ANALYSIS COMPARING THE PHYSICAL CHARACTERISTICS, INFECTION
RATE, AND COST OF ALLOGRAFTS VERSUS AUTOGRAFTS IN ANTERIOR
CRUCIATE LIGAMENT RECONSTRUCTION.
Submitted by: Sham Persaud
Saint Leo University Undergraduate Student
(Biology Major, Chemistry Minor, and Honors Student)
INTRODUCTION
Major Intra-articular Ligament And The Most Commonly Injured Ligament Of The Knee
Is Needed For Support And Strength Of The Knee
Also Used For Preventing Extreme Translation Of The Tibia Relative To The Femur
100,000 – 250,000 ACL Disruptions Per Year 50,000 Require ACL Reconstruction
IKDC
IKDC Score = (Some of Items/Maximum Possible Score) X 100
1. Effusion 2. Passive Motion Deficit 3. Ligament Examination 4. Compartment Findings 5. Harvest Site Pathology 6. X-ray Findings 7. Functional Test
LYSHOLM SCORE
Limp (5 points) Pain (25 points) Support (5 points) Locking (15 points) Swelling (10 points) Instability (30 points) Stair Climbing (10 points) Squatting (5 points)
KT-1000
The KT-1000 knee arthrometer is an objective instrument to measure anterior
tibial motion relative to the femur for anterior
cruciate ligament (ACL) reconstruction.
PHYSICAL DATA COMPARISONTable 1Clinical Outcome Studies of Allograft Versus Autograft Knee Anterior Cruciate Ligament Reconstruction
Study Allograft Type
Autograft Type
Number of Allograft Patients
Number of Autograft Patients
IKDC(Allo/Auto)
Lysholm Score
(Allo/Auto)
Tegner Score (Allo/Auto)
Kt-1000 (Allo/Auto)
Schepsis et al.2003
Quadrupled Hamstring Construct
Quadrupled Hamstring Construct
41 Patients 29 Patients 84.90/86.90 91.8/90.8 6.71/7.00 1.45mm/1.4mm
Rihn et al. 2006 BPTB BPTB 39 Patients 63 Patients 90.70/82.70 N/A N/A 1.3mm/2.2mm
Poehling et al. 2005
Achilles BPTB 41 Patients 118 Patients 89.00/50.00 N/A N/A 3.0mm/2.8mm
Barret et al. 2005
BPTB BPTB 38 Patients 25 Patients 87.00/96.00 N/A N/A 1.46mm/1.04mm
Kuskos et al. 2004
BPTB BPTB 53 Patients 26 Patients *No Difference
84.10/89.90 N/A *Allograft is slightly greater than
Autograft
Chang et al. 2003
BPTB BPTB 46 Patients 33 Patients N/A 90.70/97.00 N/A 1.2mm/1.1mm
Peterson et al. 2001
BPTB BPTB 30 Patients 30 Patients N/A 90.00/88.60 N/A *73%/67% <3mm
Kleipso et al. 1998
BPTB BPTB 36 Patients 26 Patients 85.00/69.00 N/A N/A *75%/69% <3mm
Stringham et al. 1996
BPTB BPTB 31 Patients 47 Patients N/A 90.20/90.60 *0.51/0.53 *70%/80% <3mm
Harner et al. 1996
BPTB BPTB 63 Patients 26 Patients 48.00/39.00 N/A N/A 1.8mm/1.9mm
Sun et al.2009
BPTB BPTB 80 Patients 76 Patients 75.00/72.00 91.00/90.00 7.60/7.80 2.5mm/2.4mm
*Indicates that the data was not considered for the final results.
COST COMPARISONTable 2Cost Comparison: Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction
Data Topic Allograft Autograft
Number of Allografts in Analysis 37 Patients 86 Patients
Total Cost of Procedure $4,622.00 $5,684.00
Hospital Day Price $26.00 $314.00
OR Time/Surgical Center $617.00 $912.00
Pharmacy $677.00 $1,139.00
Anesthesia $588.00 $917.00
Anesthesia Supplies $99.00 $121.00
Radiology $36.00 $123.00
OR Supplies $1,818.00 $1,534
PACU $410.00 $254.00
Laboratory $36.00 $18.00
Central Supplies $11.00 $16.00
Respiratory Care $14.00 $15.00
Cast Room $244.00 $252.00
Other $76.00 $79.00
RATE OF BACTERIAL INFECTION
Table 3Rate of Bacterial Infection: Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction
Data Topic Allograft Autograft
Number of Patients 628 Patients 170 Patients
Number of Patients with Bacterial Infection
4 Patients (.62%) 4 Patients (2.4%)