COLORADO SPRINGS, Colo. —With no differences in failure rates, patient-reported outcomes, pain or return to play, both allograft and autograft are viable options for patients undergoing medial patellofemoral ligament reconstruction.
“There is limited literature comparing autograft and allograft in medial patellofemoral ligament (MPFL) reconstruction,” Jeffrey Henstenburg, MD, said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. “Cost is time spent for harvest but theoretically, [autograft] provides superior strength and a lower retear rate. Allograft has less donor morbidity, but the cost is directly related to graft harvest,” he said.
Henstenburg and colleagues retrospectively reviewed data on 31 patients (mean age of 25.2 years) who underwent isolated MPFL reconstruction with allograft (mean follow-up of 4.57 years) and 15 patients (mean age of 26.3 years) who underwent the reconstruction with autograft (mean follow-up of 4.83 years). Outcome measures included single assessment numeric evaluation (SANE), VAS and IKDC scores, as well as patient demographics and complications. According to the abstract, patients who underwent concomitant tibial tubercle osteotomy and trochleoplasty or had a follow-up of less than 2 years were excluded.
Overall, researchers found no significant differences in any outcome measure. Patients who underwent allograft reconstruction had a mean SANE score of 66.7, a mean VAS score of 35.7 and a mean IKDC score of 68.3. Patients who underwent autograft reconstruction had a mean SANE score of 74.5, a mean VAS score of 22.9 and a mean IKDC score of 76.2. Average return to play rate was 5.9 months in the allograft cohort and was 5.2 months in the autograft cohort. Henstenburg noted one patient in the allograft group required revision surgery.
“We found no significant differences among patient-reported outcomes [and] revision rates when comparing allograft and autograft for MPFL reconstruction, and both remain viable options,” Henstenburg concluded.