Low failure rates and satisfactory PROMs in ACL reconstruction with decellularized porcine xenograft: Short‐term results in middle‐aged adults

Purpose To evaluate the short‐term outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction (ACLR) using a decellularized porcine xenograft, focusing on patient‐reported outcome measures (PROMs), complications and failure rates. Methods This retrospective study included 48 patients who underwent primary or revision ACLR with the Orthopure® xenograft. Preoperative and post‐operative International Knee Documentation Committee (IKDC) and Tegner scores were collected and showed remarkable improvements at different follow‐ups. Complications, reinterventions and failure rates were assessed. Post‐operative evaluations were conducted at 6, 12 and 24 months of follow‐up. The percentage of patients who achieved the patient acceptable symptom state (PASS) was calculated too. Results The mean age at surgery was 39.9 ± 8.5 years, with a mean follow‐up of 19.5 ± 7.0 months. Primary ACLR was performed in 42 patients (87.5%), and revision surgery in 6 patients (12.5%). An associated meniscal procedure was performed in 38 cases (79.2%). Reoperation was required in 4 patients (8.1%) due to tibial tunnel enlargement or hardware‐related complications. Graft failure occurred in 2 patients (4.1%). PASS was achieved in 45 patients (94%). Conclusion ACLR using a porcine‐derived xenograft appears to be a safe procedure with good clinical outcomes, a low rate of complications and graft failure. However, further studies with longer follow‐up and including high‐risk patients are warranted to better assess the long‐term performance of this graft. Level of Evidence Level IV, case‐series.