Differences in Outcomes and Failure Rates Between Allografts and Autografts in Revision Anterior Cruciate Ligament Reconstruction
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: ACL Injury, Graft Failure. Basic parameters: 18 years — 50 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Italy
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Anterior cruciate ligament (ACL) rupture is one of the most common knee injuries, particularly in young and physically active individuals. Despite advances in reconstruction techniques, graft failure and rerupture remain clinically relevant. Revision ACL surgery is more complex than primary reconstruction and is associated with inferior outcomes, with rerupture rates of approximately 13%, reaching up to 25% when both subjective and objective failure criteria are considered. The main goal of ACL reconstruction is to restore anteroposterior and rotational knee stability, prevent secondary meniscal and cartilage damage, and enable return to sport. Surgical outcomes depend on several intraoperative factors, including graft choice and tunnel geometry, which are particularly relevant in revision settings. Diagnosis of ACL rerupture is primarily clinical, based on instability tests (Lachman, anterior drawer, pivot shift), and supported by instrumental assessment such as the KT-1000 arthrometer, which provides an objective measure of joint laxity. Revision ACL reconstruction can be performed using different surgical techniques (single-bundle, double-bundle, or combined extra-articular procedures) and graft types (autograft or allograft). Surgical strategy depends on multiple factors such as meniscal and cartilage status, previous surgery characteristics, tunnel positioning/enlargement, and fixation devices. However, no consensus exists regarding the optimal approach in terms of mid- to long-term outcomes. A major long-term complication is the development of osteoarthritis, particularly in this typically young and active patient population. Identification of modifiable factors, such as surgical technique and graft type, may help reduce failure risk and joint degeneration. This study aims to evaluate clinical and radiographic outcomes over a follow-up period exceeding two years in patients undergoing revision ACL reconstruction with different surgical techniques and graft types. The study also integrates objective knee laxity assessment using KT-1000 and markerless motion analysis based on artificial intelligence. Functional movements are recorded via video and analyzed using Sports2D software, enabling 2D kinematic analysis without markers or sensors, providing quantitative functional data to complement clinical and radiographic evaluation.
Primary outcome measures
- Survival rate [Time frame: At least 24 months after surgery]
Secondary outcome measures (9)
- Lysholm Knee Score [Time frame: At least 24 months after surgery]
- International Knee Documentation Committee - Objective Knee Evaluation Form [Time frame: At least 24 months after surgery]
- Anterior drawer test [Time frame: At least 24 months after surgery]
- Lachman test [Time frame: At least 24 months after surgery]
- Pivot shift test [Time frame: At least 24 months after surgery]
- Tegner Activity Scale [Time frame: At least 24 months after surgery]
- WOMAC [Time frame: At least 24 months after surgery]
- KT-1000 [Time frame: At least 24 months after surgery]
- Post-operative movement analysis [Time frame: At least 24 months after surgery]
Eligibility criteria
Inclusion criteria
- Age 18-50 years at the time of surgery
- Male and female patients
- Patients undergoing revision anterior cruciate ligament (ACL) reconstruction with possible associated procedures, with at least 2 years of follow-up
- Written informed consent to participate in the study
Exclusion criteria
- Patients lost to follow-up
- Refusal to provide informed consent
- Advanced knee osteoarthritis (Outerbridge grade III-IV) at the time of surgery
- Severe obesity (BMI > 35)
- Lower limb conditions preventing full weight-bearing standing during evaluation
- Active infection, hematologic disease, or rheumatologic disease at the time of assessment
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Italy · 1 center
- IRCCS Rizzoli Orthopedic Institute — Bologna
Identifiers
NCT: NCT07671235 · ACLREV_GRAFT