Age As a Factor For Difference In Graft Type Used In ACLR Surgery

DEMOREST — It’s well-known that knee injuries are more common in female athletes than with male athletes, as are knee surgeries. Erica Balkum, a senior health science major and volleyball player, wanted to discover what types of anterior cruciate reconstruction (ACLR) surgery might work best.

“I particularly studied the difference between autografts and allografts used for anterior cruciate ligament reconstruction surgery, and how these differences may affect surgeons choosing a specific graft type for certain age groups,” she said.

As a volleyball player Balkum spends hours in the training room, but not for the reason one might think. She gains experience working with athletes to build knowledge for her future profession as a physician assistant in orthopedics. She will see many ACLR surgeries and assist the orthopedic surgeon in procedures. At the 2020 Piedmont Symposium, Erica gave her virtual speech on “Age As a Factor For Difference In Graft Type Used In ACLR Surgery.”

“I chose my topic because of my interest in sports medicine, specifically the surgical aspect,” she said.

Looking at young, mid-aged, and older patients she was able to evaluate her hypotheses. One being confirmed and another was opposed.

“There would be no difference in graft type used by the age group,” said Balkum.

There are two common types of ACLR surgeries. Allografts uses grafts from a cadaver, while autografts use the middle-third of the patient’s tendon. Discovering that 71% of patients used allografts despite previous readings stating they were inferior to autografts, she was surprised when doing her research. The allografts used in her study had been through new and alternative sterilization process, allowing the graft type to be highlighted and eliminate the disadvantages.

Physical therapist Chris Olsen was not surprised by the findings. “There is not a huge difference in healing and the outcomes of each were essentially the same.”

Dealing mostly with allograft, which is a cadaver graft, and autograft, a bone-tendon-bone harvest, he stated that most doctors he works with in Tampa, Florida only use those types.

“Age is the most important in recovery. Teens heal quicker than those over thirty years old,” he said. “Also overall health and fitness level are big factors in healing, usually less unfit people with lower muscle mass have a slower healing process, and those with more muscle mass have a quicker healing process.”

Compliance with the physical therapy and home exercise programs also play a huge role in the six-month recovery. People who do the work get better quicker, right?

“Basically I learned that my current findings showcased how the medical world and certain methods and techniques, are constantly evolving,” said Balkum. “The improvements allow for previously frowned upon concepts, in this case allografts, to sometimes surpass their counterparts (autografts), in both efficiency and practicality.”

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