Failure of Primary Anterior Cruciate Ligament Surgery Using Anterior Tibialis Allograft

Manuj C. Singhal, James R. Gardiner, Darren L. Johnson

Research output: Contribution to journalArticlepeer-review

94 Scopus citations


Purpose: The purpose of this study was to evaluate the outcome of anterior cruciate ligament (ACL) reconstruction via anterior tibialis tendon allograft. Methods: We performed a retrospective review of 125 consecutive patients who underwent ACL reconstruction via an anterior tibialis tendon allograft. Of these patients, 69 were available for follow-up at a mean of 55 months (range, 42 to 74 months); their mean age was 31.7 years (range, 19 to 69 years). Clinical evaluation consisted of the Lysholm knee score, activity level assessment, and International Knee Documentation Committee assessment. Results: Of the 69 patients, 16 (23.1%) required revision ACL reconstruction for graft failure. In addition, 26 patients (37.7%) required repeat surgery, including 16 revision ACL reconstructions, 9 arthroscopic meniscal surgeries, and 1 total knee arthroplasty. The mean age of those patients in whom failure occurred was 22.8 years compared with 34 years in those in whom failure did not occur (P = .0039). The failure/reoperation rate of those aged 25 years or under was 55% (17/31), as compared with 24% (9/38) in those aged over 25 years. The mean Lysholm knee score was 85.6 (range, 15 to 100), and the mean activity score was 4.36 (range, 0 to 9). Of the 52 patients who did not require revision ACL surgery, 86.2% rated their knee as normal or nearly normal. Conclusions: A reoperation rate of 38% after primary ACL surgery is high. We do not recommend the use of anterior tibialis allograft in young patients (aged ≤25 years) or those who participate frequently in level I ACL-dependent sports. Level of Evidence: Level IV, therapeutic case series.

Original languageEnglish
Pages (from-to)469-475
Number of pages7
Issue number5
StatePublished - May 2007


  • Allograft
  • Anterior cruciate ligament
  • Revision

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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