Fibular Collateral Ligament Reconstruction Graft Options: Clinical and Radiographic Outcomes of Autograft Versus Allograft

PurposeTo compare varus knee stability and clinical outcomes between patients who underwent fibular collateral ligament reconstruction (FCLR) or lateral collateral ligament (LCL) reconstruction with autografts versus allografts when undergoing concomitant anterior cruciate ligament reconstruction (ACLR).MethodsAll patients who underwent primary ACLR and concomitant FCLR from 2010 to 2017 performed by a single surgeon (R.F.L.) were retrospectively identified. Clinical characteristics and graft choices for FCLR were collected. Patients with a minimum 2-year follow-up for clinical outcome scores and 6-month stress radiographs were included. Patients with any other ligamentous procedure or revision ACLR were excluded.ResultsWe identified 69 primary ACLR with concomitant FCLR patients who met the inclusion criteria. Fifty patients underwent FCLR with semitendinosus autografts, and 19 with allografts. There were no significant side-to-side differences (SSDs) in lateral compartment gapping on varus stress x-rays between the 2 cohorts (allograft, 0.49 mm; autograft, 0.15 mm, P = .22), and no FCLR failures. There were no significant differences between autograft and allograft groups at minimum 2-year outcomes for 12-Item Short Form mental or physical composite score (SF12 MCS, P = .134; SF12 PCS, P = .642), WOMAC total (P = .158), pain (P = .116), stiffness (P = .061), or activity (P = .252); International Knee Documentation Committee (IKDC) (P = .337), Tegner (P = .601), Lysholm (P = .622), or patient satisfaction (P = .218). There were no significant differences in clinical knee stability between groups at an average follow-up of 3.6 years (P = 1.0).ConclusionThere were no differences in varus stress laxity 6 months postoperatively or clinical outcome scores at ≥2 years postoperatively between patients having FCL reconstructions with either autograft or allograft. This study demonstrates that both hamstring autografts and allografts for FCL reconstructions offer reliable and similar radiographic and clinical results at short-term follow-up.Level of EvidenceIII, retrospective comparative trial.