| Purpose: To compare the clinical efficacy of ACL reconstruction with autograft,allograft and LARS ligament,and to find the reasons for graft failure or non-return to sport.Methods: This retrospective study received patients who underwent ACL reconstruction and got complete phone follow-up for isolated ACL deficiency between August 2006 and December 2012,using either autograft,allograft and LARS ligament.The Kneelax 3,Lachman test,pivot shift test,thigh muscle atrophy and range of motion(ROM)were assessed for objective knee function.IKDC subjective score,Lysholm knee scoring scale,Tegner activity level and KOOS grade were assessed for subjective knee function.Postoperative distribution of tunnel position,tunnel widening and graft failure and complications the situation of return to sport were also calculated.Results: 185 patients achieved the mean follow-up of 86.4 months(range,60-132 months),and the average age was 31.5 years old(range,13-57 years).There were no statistically significant difference between the three groups regarding all the clinical objective,subjective results,tunnel widening,return to sport rate,complication rate or graft failure rate(P>0.05).Vertically compare pre-injury,preoperative(after injury)and postoperative functional and motorial scores,we found that preoperative(after injury)Lysholm scores were inferior to postoperative Lysholm scores(P<0.01),preoperative(after injury)Tegner scores were inferior to postoperative Tegner scores and postoperative Tegner scores were inferior to pre-injury Tegner scores(P<0.01),three groups were consistent.In terms of the intra-articular aperture position of femoral tunnel,the intra-articular aperture malposition of femoral tunnel was significantly associated with graft failure(P<0.05),three groups were consistent.Conclusions: ACL reconstruction with autograft,allograft or LARS ligament could improve the functional and motorial level of the knee,but patients had great difficulty in regaining the level of pre-injury sports.There were no statistically significant differences among three grafts after ACL reconstruction in terms of the clinical outcomes at the medium-term follow-up.In addition,the intra-articular aperture position of the femoral tunnel was an important factor affecting the success of the operation,the intra-articular aperture malposition of the femoral tunnel would partly lead to graft failure. |
