Patients’ Under 25 Subjective Readiness to Return to Sport After ACL Reconstruction with Bone-Patellar-Bone Grafts: Autograft vs. Allograft

Purpose To assess the difference in perceived readiness to return to sport (RTS) within the first year postoperative period between individuals undergoing anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone (BTB) autografts or allografts. Methods This was a prospective cohort study of patients undergoing primary ACL reconstruction done either with BTB autograft or allograft from 2010 to 2018. Skeletally mature patients aged 14 to 25 were eligible for inclusion. Patients completed the Marx Activity Rating Scale (MARS) questionnaire postoperatively evaluating perceived ability to perform various activities to compare subjective ability to RTS. Those patients who were outside outlined cohort age, failed to complete a single post-operative survey, underwent revision procedures, or underwent simultaneous or staged additional ligament surgery were excluded. Results Fifty-nine patients (20.1±3.19 years, 57.6% Male) were included in the study. Sixteen patients underwent ACL reconstruction with allograft (19.8±3.43 years) while 43 patients received autograft (20.2±3.13). At 3 months autograft recipients reported higher perceived ability to cut (P=0.003). At 6-months, allograft recipients reported higher perceived ability to run (P=0.033), cut (P=0.048), and decelerate (P=0.008) as well as a higher overall perceived ability to RTS (P=0.032). At all other times, there was no significant difference between cohorts’ subjective readiness to perform activities. Conclusion The results of this study indicate that at times within the first year of recovery following ACL reconstruction, patients who receive allografts and autografts may have significantly different perceived ability to perform activities or RTS. However, while present at various times throughout the first year of recovery, any difference in perceived ability to perform activities or in overall RTS is no longer present at 12 months. Level of Evidence Level II, Prospective cohort study