1. A L ITERATURE A NALYSIS C OMPARING THE P HYSICAL C HARACTERISTICS, I NFECTION R ATE, AND C OST OF A LLOGRAFTS VERSUS A UTOGRAFTS IN A NTERIOR C RUCIATE L IGAMENT R ECONSTRUCTION. Submitted by: Sham Persaud Saint Leo University Undergraduate Student (Biology Major, Chemistry Minor, and Honors Student)

2. I NTRODUCTION Major Intra-articular Ligament And The Most Commonly Injured Ligament Of The Knee Is Needed For Support And Strength Of The Knee Also Used For Preventing Extreme Translation Of The Tibia Relative To The Femur 100,000 – 250,000 ACL Disruptions Per Year 50,000 Require ACL Reconstruction

5. H OW ACL T EARS O CCUR

6. A UTOGRAFTS

7. A LLOGRAFTS

8. S URGERY S UMMARY www.youtube.com/watch?v=q96M0jRqn7k

9. M ETHODS

10. IKDC IKDC Score = (Some of Items/Maximum Possible Score) X 100 1. Effusion 2. Passive Motion Deficit 3. Ligament Examination 4. Compartment Findings 5. Harvest Site Pathology 6. X-ray Findings 7. Functional Test

11. L YSHOLM S CORE Limp (5 points) Pain (25 points) Support (5 points) Locking (15 points) Swelling (10 points) Instability (30 points) Stair Climbing (10 points) Squatting (5 points)

12. T EGNER S CORE Activity Scale Scores Range From 0-10

13. KT-1000 The KT-1000 knee arthrometer is an objective instrument to measure anterior tibial motion relative to the femur for anterior cruciate ligament (ACL) reconstruction.

14. P HYSICAL D ATA C OMPARISON Table 1 Clinical Outcome Studies of Allograft Versus Autograft Knee Anterior Cruciate Ligament Reconstruction Study Allograft Type Autograft Type Number of Allograft Patients Number of Autograft Patients IKDC (Allo/Auto) Lysholm Score (Allo/Auto) Tegner Score (Allo/Auto) Kt-1000 (Allo/Auto) Schepsis et al. 2003 Quadrupled Hamstring Construct 41 Patients29 Patients84.90/86.9091.8/90.86.71/7.001.45mm/1.4mm Rihn et al. 2006BPTB 39 Patients63 Patients90.70/82.70N/A 1.3mm/2.2mm Poehling et al. 2005 AchillesBPTB41 Patients118 Patients89.00/50.00N/A 3.0mm/2.8mm Barret et al. 2005 BPTB 38 Patients25 Patients87.00/96.00N/A 1.46mm/1.04mm Kuskos et al. 2004 BPTB 53 Patients26 Patients *No Difference 84.10/89.90N/A *Allograft is slightly greater than Autograft Chang et al. 2003 BPTB 46 Patients33 PatientsN/A90.70/97.00N/A1.2mm/1.1mm Peterson et al. 2001 BPTB 30 Patients N/A90.00/88.60N/A*73%/67% <3mm Kleipso et al. 1998 BPTB 36 Patients26 Patients85.00/69.00N/A *75%/69% <3mm Stringham et al. 1996 BPTB 31 Patients47 PatientsN/A90.20/90.60*0.51/0.53*70%/80% <3mm Harner et al. 1996 BPTB 63 Patients26 Patients48.00/39.00N/A 1.8mm/1.9mm Sun et al. 2009 BPTB 80 Patients76 Patients75.00/72.0091.00/90.007.60/7.802.5mm/2.4mm *Indicates that the data was not considered for the final results.

15. C OST C OMPARISON Table 2 Cost Comparison: Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction Data TopicAllograftAutograft Number of Allografts in Analysis37 Patients86 Patients Total Cost of Procedure$4,622.00$5,684.00 Hospital Day Price$26.00$314.00 OR Time/Surgical Center$617.00$912.00 Pharmacy$677.00$1,139.00 Anesthesia$588.00$917.00 Anesthesia Supplies$99.00$121.00 Radiology$36.00$123.00 OR Supplies$1,818.00$1,534 PACU$410.00$254.00 Laboratory$36.00$18.00 Central Supplies$11.00$16.00 Respiratory Care$14.00$15.00 Cast Room$244.00$252.00 Other$76.00$79.00

16. R ATE O F B ACTERIAL I NFECTION Table 3 Rate of Bacterial Infection: Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction Data TopicAllograftAutograft Number of Patients628 Patients170 Patients Number of Patients with Bacterial Infection 4 Patients (.62%)4 Patients (2.4%)

17. C ONCLUSION No Significant Difference In Physical Characteristics Significant Difference In Cost (Pro-Allograft) No Significant Difference In Bacterial Infection (Favored Allograft) Allograft Use Was Shown To Be A Viable And Successful ACL Reconstruction Technique.