Date

May 2010

Document Type

Thesis

Degree Name

M.P.H.

Department

Dept. of Public Health and Preventive Medicine

Institution

Oregon Health & Science University

Abstract

Anterior cruciate ligament (ACL) tears are a common knee injury. Surgical reconstruction of the ligament requires graft tissue. Autograft tissue, the standard of care, is obtained from the patient’s own leg during surgery. Allograft tissue is procured from deceased human donors. Risk of peri-operative complication events associated with graft type is poorly characterized. We used a retrospective cohort design to quantify risk of morbidity, defined as complication events in six months following primary arthroscopic ACL reconstruction. The patient cohort was identified through billing record queries for specific diagnostic and procedure codes. Patient demographics, graft type, and surgical information were abstracted from medical records. Complication events were identified through queries for specific diagnostic and treatment codes occurring in the six months following surgery. Risk of morbidity among patients receiving allograft tissue was compared to risk among patients receiving autograft tissue with Cochran Mantel Haenszel adjusted estimates of relative risk (RR) and 95% confidence intervals (CI). The cohort included 413 patients. Average age was 33 (±12) years, 65% were male, and 66% received allograft tissue for ACL reconstruction. The six month risk of morbidity was 5% in the cohort: 7% among patients receiving allograft and 2% among patients receiving autograft tissue. After adjustment for patient sex, the RR for any complication was 3.0 (95% CI: 0.9-9.7) comparing allograft use with autograft use. These results will help patients and surgeons weigh the short term risks and benefits of choosing allograft or autograft tissue for use in ACL reconstruction.

Identifier

doi:10.6083/M4BK199X

School

School of Medicine

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