Allograft Use Results in Higher Re-revision Rate for Revision Anterior Cruciate Ligament Reconstruction

Abstract

Background: The literature on revision anterior cruciate ligament (ACL) reconstruction (ACLR) outcomes is generally sparse, but previous studies have demonstrated that autograft use results in improved sports function and patient-reported outcome measures compared with allograft. However, knowledge is still lacking regarding the impact of graft type on rates of re-revision. Purpose: To investigate the clinical outcomes and failure rates of revision ACLRs performed with either allograft or autograft. Study Design: Cohort study; Level of evidence, 3. Methods: A search of the Danish Knee Ligament Reconstruction Registry identified 1619 revision ACLRs: 1315 were autograft procedures and 221 were allograft procedures (type of graft was not identified for 83 procedures). Clinical outcomes after 1 year were reported via the Knee injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity score, and an objective knee stability measurement that determined side-to-side differences in instrumented sagittal knee laxity. Failure was determined as re-revision. Outcomes for revision were provided for the full life of the registry, up to 10 years. Results: The re-revision rate was significantly higher for allograft compared with autograft (12.7% vs 5.4%; P