# Anterior Cruciate Ligament Reconstruction With Fresh Frozen Soft Tissue Allograft: A Retrospective Case Series

## TL;DR

This study evaluated the effectiveness of fresh frozen soft tissue allografts for ACL reconstruction in India and found satisfactory outcomes with few complications.

## Contribution

The study provides evidence supporting the use of fresh frozen allografts as a standard option for ACLR in non-athletic Indian patients.

## Key findings

- Fresh frozen allografts showed statistical non-inferiority in one-leg hop distance compared to the non-operated limb.
- Two patients experienced graft necrosis requiring revision surgery, but others had near-normal function.
- No cases of re-rupture or disease transmission were observed.

## Abstract

Objectives

The purpose of this study was to assess the outcomes of fresh frozen soft tissue allografts in anterior cruciate ligament reconstruction (ACLR) in India.

Methods

This retrospective case series involves patients who underwent ACLR with allografts between February 2015 and October 2015 at Aware Global Hospitals, Hyderabad, and were contacted in October 2016 for follow-up. At follow-up, these patients completed questionnaires and underwent clinical examination. A one-tailed paired t-test was used to assess the non-inferiority of the operated limb compared with the contralateral limb in the one-leg hop distance.

Results

Of the 14 patients, four (28.6%) developed fever and joint swelling in the immediate postoperative period. At repeat arthroscopy, two (50%) of these four patients had intact grafts, while the other two (50%) had necrosed grafts. Both patients with graft necrosis required revision ACLR. Excluding these two patients (14.3%), all the others were symptomatically, functionally, and clinically near normal at the last follow-up visit. There were no cases of re-rupture or disease transmission. The mean difference in one-leg hop distance between the operated and non-operated limbs was −1.92 inches (SD 2.47). The upper bound of the 90% one-sided confidence interval (−0.95 inches) was well below the non-inferiority margin of 4.3 inches (p<0.000001), demonstrating statistical non-inferiority.

Conclusion

Fresh frozen soft tissue allograft use produced satisfactory outcomes in our patients. In the Indian population, where most anterior cruciate ligament (ACL) injuries occur in non-athletic individuals, fresh frozen soft tissue allografts can be considered a standard graft material for ACLR.