Noyes (1996) — Reconstruction of the anterior cruciate ligament with human allograft. Comparison of early and later results.

Reconstruction of the Anterior Cruciate Ligament with Human Allograft. Comparison of Early and Later Results.

Noyes, Barber-Westin·J Bone Joint Surg Am·1996·174 citations·Sports Medicine

This longitudinal cohort study followed 68 patients who underwent ACL reconstruction with fascia lata or bone-patellar ligament-bone allografts for acute ACL ruptures, comparing outcomes at 2–4 years and again at 5–9 years (mean 7 years) postoperatively — the first study to track the same patient cohort across both time points.

Study Snapshot

Design

Retrospective cohort

Setting: Single center, Cincinnati

Funding: Cincinnati Sportsmedicine Foundation

Objective

Whether ACL allograft reconstruction maintains stability and function at 5–9 years

Outcome(s)

Change in anterior-posterior displacement and overall knee rating 5–9 years postop

Subjects

68 patients, acute ACL rupture, two follow-up evaluations

40Fascia lata allograft
28Bone-patellar ligament-bone allograft

Inclusion

Acute complete ACL rupture
Skeletally mature
Minimum 5-year follow-up available

Exclusion

Bilateral ACL rupture
Traumatic allograft rupture within year 1
Died before 5-year follow-up

Follow-up

Mean 7 years (5–9)

Statistics

Paired Student t-testChi-square with Yates correctionStepwise linear regression

Key Findings

Knee stability held: 78% vs. 79% of patients had <3 mm anterior-posterior displacement at early vs. Later follow-up (p=0.97), with no significant deterioration in arthrometric values over time
Graft function was durable: 75% functional early vs. 74% later; failure rate rose modestly from 3% to 7%, with only 3 grafts failing by progressive stretch between evaluations
Patellofemoral crepitus increased over time — 93% had no crepitus early vs. 75% later; 19% of patients with normal early crepitus developed crepitus by later follow-up, and this was significantly linked to overall rating deterioration (p=0.04)
Overall ratings were stable: 60% excellent/good early vs. 66% later; only 13% deteriorated from excellent/good to fair/poor, while 9% actually improved
Bone-patellar ligament-bone allografts outperformed fascia lata allografts on subjective measures at later follow-up:
–Pain (p=0.009)
–Swelling (p=0.006)
–Stair-climbing (p=0.006)
–Twisting/turning (p=0.006)

Clinical Relevance

When autograft harvest is contraindicated or the patient declines donor-site morbidity, allograft ACL reconstruction produces durable stability through 7 years — but counsel patients that patellofemoral symptoms may develop over time and that bone-patellar ligament-bone allografts appear to yield better subjective functional outcomes than fascia lata grafts.

Supplemental

Reconstruction of the Anterior Cruciate Ligament with Human Allograft. Comparison of Early and Later Results.

Noyes, Barber-Westin·J Bone Joint Surg Am·1996·174 citations·Sports Medicine

Reconstruction of the Anterior Cruciate Ligament with Human Allograft. Comparison of Early and Later Results.

Study Snapshot

Key Findings

Clinical Relevance

Related Articles

Reconstruction of the Anterior Cruciate Ligament with Human Allograft. Comparison of Early and Later Results.

Study Snapshot

Key Findings

Clinical Relevance

Related Articles

Reconstruction of the Anterior Cruciate Ligament with Human Allograft. Comparison of Early and Later Results.

Study Snapshot

Key Findings

Clinical Relevance

Related Articles

Reconstruction of the Anterior Cruciate Ligament with Human Allograft. Comparison of Early and Later Results.

Study Snapshot

Key Findings

Clinical Relevance

Related Articles