B-PT-B Allograft in Primary A.C.L. Reconstruction

The A.C.L tear is one of the most common injuries seen by Orthopaedic Surgeons.

A.C.L. Reconstruction can be done with several different graft choices.

These most common options include Patella tendon, Hamstrings tendon, and donor tissue (Allograft).

The Autologous bone-patellar tendon-bone (B-PT-B)autograft has long been the graft of choice for reconstruction of the ligament. It has higher tensile load and stiffness compared with the native A.C.L. This graft has enjoyed a 30 years track record for stabilizing an A.C.L-deficient knee.

It has some limitations in regard to donor-site morbidity, including patella fracture, post operative patella baja, and persistent anterior knee pain or kneeling pain.

The use of Allograft for primary A.C.L. reconstruction has increased steadily over the past decade, and the demand is expected to increase.

Allograft eliminate the disadvantages associated with autografts, including the perioperative pain and graft-site morbidity associated with harvesting a graft.

Others advantages of the Allograft are, decrease operative time, no need to remove other tissue to use for the graft, and smaller incisions.

The disadvantages is the risk to disease transmission, but more recently techniques

of Allograft preparation have improved dramatically and these concerns are less of and issue.

A Bone-Patellar tendon-Bone (B-PT-B) is one of the strongest grafts concerning the initial fixation. This is due to the fact that there is bone on each end of the graft

that is going into a tunnel in the bone.

The fixation is one of many factors that will determine how soon one progress through their rehabilitation and allowed to return to full athletic participation.

The A.A.O.S. recommends using only tissue banks that are accredited by the American Association of Tissue Banks registered with the US F.D.A and certified

by the international organization for standardization.

We use B-PT-B Allograft from the M.T.F.(Musculoskeletal Transplant Foundation)

We performed in 24 patients primary A.C.L. Reconstruction with freeze ALLOGRAFT

B-PT-B with very good results and without complication in 5 year follow up.

We presented our experience, the preparation of the graft and the operative technique performed arthroscopically.