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Risk of bacterial infection after ACL reconstruction no higher when using allograft tissue versus autograft tissue, study shows
Thursday, December 04 2008 | Comments
What's This?
The incidence of bacterial joint infection following anterior cruciate ligament (ACL) reconstruction is not any higher when allograft tissue is used versus when autograft tissue is used, according to a recent study.Researchers conducted a retrospective medical record review for ACL reconstructions performed between January 2001 and December 2005 at their institutions. The patients' charts were assessed for demographic data, comorbidities, preoperative antibiotics, fixation type, and deep postoperative infection requiring hospital admission.
A total of 801 knees in 782 patients were included in the study. Of these, 170 knees received autograft tendons and 628 knees received allograft tendons. Three cases had a reconstruction using a combination of the 2 tissue types. Patients in the allograft group were older (P<.0001) and had slightly more prior surgeries (P=.01).
Overall, 6 postoperative infections were detected (0.75%; 95% CI, 0.15-1.35). Four of these cases had allograft tissue (0.63%; 95% CI, 0.01-1.26) and 2 infections occurred with autograft tissue (1.2%; 95% CI, 0-2.8). All 4 cases of autograft tissue infection came from the group of the 118 patients who received semitendinosusgracilis hamstrings (1.69%; 95% CI, 0-4.02).
Multivariate analysis demonstrated that patients who had ACL reconstruction with autograft tissue had nearly twice the risk of infection as compared with patients who had allograft tissue (adjusted OR, 1.83; 95% CI, 0.16-12.94). However, this finding was not statistically significant (P=.77).
"This study failed to find a higher rate of deep bacterial infection in ACL reconstructions when allograft tissue was used," the authors concluded. "We, therefore, feel that surgeons should consider allograft tissue as an alternative to autograft when there is concern about donor-site morbidity, or for revision reconstructions." (Katz LM, et al. Arthroscopy 2008:24:1330-1335.)
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