Low failure rates and satisfactory PROMs in ACL reconstruction with decellularized porcine xenograft: Short-term results in middle-aged adults.

Abstract

To evaluate the short-term outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction (ACLR) using a decellularized porcine xenograft, focusing on patient-reported outcome measures (PROMs), complications and failure rates. This retrospective study included 48 patients who underwent primary or revision ACLR with the Orthopure® xenograft. Preoperative and post-operative International Knee Documentation Committee (IKDC) and Tegner scores were collected and showed remarkable improvements at different follow-ups. Complications, reinterventions and failure rates were assessed. Post-operative evaluations were conducted at 6, 12 and 24 months of follow-up. The percentage of patients who achieved the patient acceptable symptom state (PASS) was calculated too. The mean age at surgery was 39.9 ± 8.5 years, with a mean follow-up of 19.5 ± 7.0 months. Primary ACLR was performed in 42 patients (87.5%), and revision surgery in 6 patients (12.5%). An associated meniscal procedure was performed in 38 cases (79.2%). Reoperation was required in 4 patients (8.1%) due to tibial tunnel enlargement or hardware-related complications. Graft failure occurred in 2 patients (4.1%). PASS was achieved in 45 patients (94%). ACLR using a porcine-derived xenograft appears to be a safe procedure with good clinical outcomes, a low rate of complications and graft failure. However, further studies with longer follow-up and including high-risk patients are warranted to better assess the long-term performance of this graft. Level IV, case-series.