COMPARISON OF FUNCTIONAL OUTCOMES AND KINESIOPHOBIA LEVELS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH HAMSTRING TENDON AUTOGRAFT VERSUS FRESH-FROZEN ALLOGRAFT: A CROSS-SECTIONAL STUDY

Öz

Objective: Determining the best graft in the selection of various graft types for anterior cruciate ligament reconstruction (ACLR) is still unclear. The study aimed to compare the functional outcomes and kinesiophobia among individuals who underwent ACLR with either hamstring tendon autograft or fresh-frozen allografts and healthy individuals. Method: A total of 44 individuals undergoing ACLR and 30 healthy individuals were assessed. Individuals who underwent ACLR with hamstring tendon autograft (Group 1) or fresh-frozen allograft (Group 2) and a control group with similar activity levels (Group 3) were included in this study. The surgical groups were evaluated 12-48 months after surgery. Evaluations included detailed history, knee muscle strength, single-leg hop test, and kinesiophobia. Results: There were 24 individuals (mean age 31.71±9.78 years) in Group 1, 20 individuals (mean age 32.35±5.58 years) in Group 2, and 30 healthy controls (mean age 33.77±7.09 years) in Group 3. There was no difference between the surgical groups in terms of single-leg hop test, kinesiophobia, and muscle strength (p>0.05). However, there were significant differences between the ACLR groups with the control group in terms of muscle strength of injured side (p<0.002), single-leg hop test (p<0.029), and kinesiophobia level (p=0.005). Conclusion: This study showed that no graft type was superior to another in terms of functional outcomes and kinesiophobia after ACLR. In addition, the need for long-term rehabilitation of individuals with ACLR should be taken into consideration to reach their pre-operative functional level.

Anahtar Kelimeler

• Allografts
• Autografts
• Anterior Cruciate Ligament Reconstruction
• Kinesiophobia
• Functional Performance

Kaynakça

1. Kim S, Bosque J, Meehan JP, et al. Increase in outpatient knee arthroscopy in the United States: a comparison of National Surveys of Ambulatory Surgery, 1996 and 2006. J Bone Joint Surg Am. 2011;93(11):994-1000.
2. Moses B, Orchard J, Orchard J. Systematic review: annual incidence of ACL injury and surgery in various populations. Res Sports Med. 2012;20(3-4):157-179.
3. Zeng C, Gao S-g, Li H, et al. Autograft versus allograft in anterior cruciate ligament reconstruction: a meta-analysis of randomized controlled trials and systematic review of overlapping systematic reviews. Arthroscopy. 2016;32(1):153-163.
4. West RV, Harner CD. Graft selection in anterior cruciate ligament reconstruction. J Am Acad Orthop Surg. 2005;13(3):197-207.
5. Wang S, Zhang C, Cai Y, et al. Autograft or Allograft? Irradiated or Not? A contrast between autograft and allograft in anterior cruciate ligament reconstruction: a meta-analysis. Arthroscopy. 2018;34(12):3258-3265.
6. Sun K, Zhang J, Wang Y, et al. A prospective randomized comparison of irradiated and non-irradiated hamstring tendon allograft for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2012;20(1):187-194.
7. Maletis GB, Chen J, Inacio MC, et al. Increased risk of revision after anterior cruciate ligament reconstruction with bone–patellar tendon–bone allografts compared with autografts. Am J Sports Med. 2017;45(6):1333-1340.
8. Mariscalco MW, Magnussen RA, Mehta D, et al. Autograft versus nonirradiated allograft tissue for anterior cruciate ligament reconstruction: a systematic review. Am J Sports Med. 2014;42(2):492-499.

9. Tian S, Wang Y, Wang B, et al. Anatomic double-bundle anterior cruciate ligament reconstruction with a hamstring tendon autograft and fresh-frozen allograft: A prospective, randomized, and controlled study. Arthroscopy. 2016;32(12):2521-2531.
10. O’Sullivan L. Methods and Considerations for Autologous Bone Graft Processing. Surgical Technologist. 2023:14-21.
11. Goldblatt JP, Fitzsimmons SE, Balk E, et al. Reconstruction of the anterior cruciate ligament: meta-analysis of patellar tendon versus hamstring tendon autograft. Arthroscopy. 2005;21(7):791-803.
12. Sun K, Zhang J, Wang Y, et al. Arthroscopic reconstruction of the anterior cruciate ligament with hamstring tendon autograft and fresh-frozen allograft: a prospective, randomized controlled study. Am J Sports Med. 2011;39(7):1430-1438.
13. Issın, A, et al, Comparison of freeze-dried tibialis anterior allograft and four-strand hamstring autograft in anterior cruciate ligament reconstruction. Acta Orthop Traumatol Turc. 2019;53(1): p. 45-49.
14. Mardani-Kivi M, Karimi-Mobarakeh M, Keyhani S, et al. Hamstring tendon autograft versus fresh-frozen tibialis posterior allograft in primary arthroscopic anterior cruciate ligament reconstruction: a retrospective cohort study with three to six years follow-up. Int Orthop. 2016;40:1905-1911.
15. Bottoni CR, Smith EL, Shaha J, et al. Autograft versus allograft anterior cruciate ligament reconstruction: a prospective, randomized clinical study with a minimum 10-year follow-up. Am J Sports Med. 2015;43(10):2501-2509.
16. Harner CD, Olson E, Irrgang JJ, et al. Allograft versus autograft anterior cruciate ligament reconstruction: 3-to 5-year outcome. Clin Orthop Relat Res. 1996;324:134-144.
17. Lawhorn KW, Howell SM, Traina SM, et al. The effect of graft tissue on anterior cruciate ligament outcomes: a multicenter, prospective, randomized controlled trial comparing autograft hamstrings with fresh-frozen anterior tibialis allograft. Arthroscopy. 2012;28(8):1079-1086.
18. Tan TK, Subramaniam AG, Ebert JR, et al. Quadriceps tendon versus hamstring tendon autografts for anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Am J Sports Med. 2022;50(14):3974-3986.
19. Lephart SM, Kocher MS, Harner CD, et al. Quadriceps strength and functional capacity after anterior cruciate ligament reconstruction: patellar tendon autograft versus allograft. Am J Sports Med. 1993;21(5):738-743.
20. Schmitt LC, Paterno MV, Ford KR, et al. Strength asymmetry and landing mechanics at return to sport after ACL reconstruction. Med Sci Sports Exerc. 2015;47(7):1426.
21. Ardern CL, Taylor NF, Feller JA, et al. Fear of re-injury in people who have returned to sport following anterior cruciate ligament reconstruction surgery. J Sci Med Sport. 2012;15(6):488-495.
22. Ashton ML, Kraeutler MJ, Brown SM, et al. Psychological readiness to return to sport following anterior cruciate ligament reconstruction. JBJS Rev. 2020;8(3):e0110.
23. Bullock GS, Sell TC, Zarega R, et al. Kinesiophobia, knee self-efficacy, and fear avoidance beliefs in people with ACL injury: a systematic review and meta-analysis. Sports Med. 2022;52(12):3001-3019.
24. Naderi A, Fallah Mohammadi M, Dehghan A, et al. Psychosocial interventions seem redact kinesiophobia after anterior cruciate ligament reconstruction but higher level of evidence is needed: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthros. 2023;31(12):5848-5855.
25. Marok E, Soundy A. The effect of kinesiophobia on functional outcomes following anterior cruciate ligament reconstruction surgery: an integrated literature review. Disabil Rehabil. 2022;44(24):7378-7389.
26. an Wyngaarden JJ, Jacobs C, Thompson K, et al. Quadriceps Strength and Kinesiophobia Predict Long-Term Function After ACL Reconstruction: A Cross-Sectional Pilot Study. Sports Health. 2021;13(3):251-257.
27. van der Wilk S, Hoorntje A, Blankevoort L, et al. Physical activity after revision knee arthroplasty including return to sport and work: a systematic review and meta-analysis including GRADE. BMC Musculoskelet Disord. 2023;24(1):368.
28. Canale S, Beaty J. Campbell's Operative Orthopaedics E-Book: Elsevier Health Sciences. Philadelphia; 2012.
29. Orishimo KF, Kremenic IJ, Mullaney MJ, et al. Adaptations in single-leg hop biomechanics following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010;18(11):1587-1593.
30. Andrews AW, Thomas MW, Bohannon RW. Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Phys Ther. 1996;76(3):248-259.
31. Stringham DR, Pelmas CJ, Burks RT, et al. Comparison of anterior cruciate ligament reconstructions using patellar tendon autograft or allograft. Arthroscopy. 1996;12(4):414-421.
32. Stringham DR, Pelmas CJ, Burks RT, et al. Comparison of anterior cruciate ligament reconstructions using patellar tendon autograft or allograft. Arthroscopy. 1996;12(4):414-421.
33. Saddemi SR, Frogameni AD, Fenton PJ, et al. Comparison of perioperative morbidity of anterior cruciate ligament autografts versus allografts. Arthroscopy. 1993;9(5):519-524.
34. Jung S-H, Choi CH, Kim S-H, et al. Sequential Comparison of Knee Muscle Strength after Anterior Cruciate Ligament Reconstruction between Hamstring Autograft and Tibialis Anterior Allograft: Propensity Score Matched Pair Analysis. Diagnostics. 2024;14(14):1478.
35. Landes S, Nyland J, Elmlinger B, et al. Knee flexor strength after ACL reconstruction: comparison between hamstring autograft, tibialis anterior allograft, and non-injured controls. Knee Surg Sports Traumatol Arthrosc. 2010;18:317-324.
36. Ohji S, Aizawa J, Hirohata K, et al. Kinesiophobia is negatively associated with psychological readiness to return to sport in patients awaiting anterior cruciate ligament reconstruction. Arthroscopy. 2023;39(9):2048-2055.
37. Mehran N, Moutzouros VB, Bedi A. A review of current graft options for anterior cruciate ligament reconstruction. JBJS Rew. 2015;3(11).
38. Robinson Jr JD, Hannon J, Goto S, et al. Adolescent athletes demonstrate inferior objective profiles at the time of return to sport after ACLR compared with healthy controls. Orthop J Sports Med. 2022;10(1):23259671211063576.
39. Brown C, Marinko L, LaValley MP, et al. Quadriceps strength after anterior cruciate ligament reconstruction compared with uninjured matched controls: a systematic review and meta-analysis. Orthop J Sports Med. 2021;9(4):2325967121991534.
40. Hoch JM, Houston MN, Baez SE, et al. Fear-avoidance beliefs and health-related quality of life in post-ACL reconstruction and healthy athletes: A case–control study. J Sport Rehabil. 2019;29(6):772-776.