Freeze-dried fascia lata allografts in the reconstruction of anterior cruciate ligament defects. A two- to seven-year follow-up study.

Abstract

A study of 70 arthroscopic anterior cruciate ligament reconstructions with nonaugmented human freeze-dried fascia lata grafts is reported. The overall results are based on subjective, objective, and radiologic examinations as well as second-look arthroscopies at the one-year, four-year, and five-year follow-up evaluations. The average follow-up time was 4.5 years (range, two to seven years). Mention is made of pertinent points from patient histories, and an account is given of associated lesions that had been previously operated on or which were treated concomitantly. The subjective results show 82% excellent and good results, and the objective results show 95% excellent and good results. This difference may be explained by the subjective residual pain reported by every patient who suffered a work compensation injury; residual pain was not reported very often by those whose injuries were sports related. Forty-seven patients underwent second-look arthroscopies at one year, and seven underwent arthroscopy at four and five years after operation. These examinations provided very interesting clues as to the graft's future status. It was possible to identify zones of neovascularization, tissue invasion, and unraveling of the graft as well as to test for stability with a probe. Biopsies and histologic studies confirmed superficial and deep ligament revascularization as early as four months after operation. Results of arthroscopy at one year confirmed the results of physical examination and the prognosis for the graft.