Allograft Versus Autograft in Posterior Cruciate Ligament Reconstruction: An Evidence-Based Systematic Review

Hudgens, Joshua L.; Gillette, Blake P.; Krych, Aaron J.; Stuart, Michael J.; May, Jedediah H.; Levy, Bruce A.

doi:10.1055/s-0032-1319778

Cited by 50 publications

(32 citation statements)

References 29 publications

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“…[13] Currently, the graft materials available for PCL reconstruction include autologous tendons, allograft tendons, and artificial ligaments, but the clinical use of artificial ligaments is uncommon. [7] Allograft tendons are widely used in clinical practice, [10,11,13–15] such as Achilles tendons, patellar tendons, hamstring tendons, and anterior tibial tendons. Operations using allograft tendons were shown to have shorter operative times and reduced soft tissue damage, as well as the ability to have grafts of adequate length and diameter.…”

Section: Discussionmentioning

confidence: 99%

Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Tian

Hu²,

et al. 2017

Medicine

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Background:The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to compare the clinical outcomes of autograft versus allograft tendons in patients who underwent posterior cruciate ligament (PCL) reconstruction.Methods:We conducted a search of PubMed, EMBASE, The Cochrane Library, and Web of Science databases for RCTs and non-RCTs comparing autograft and allograft tendons in PCL reconstruction up to August 2016. The outcomes were Lysholm knee function score, postoperative objective and subjective International Knee Documentation Committee Score (IKDCS), Tegner activity scale, and knee posterior stability. Data analysis was performed using RevMan 5.3 software.Results:One RCT and 4 non-RCTs met the inclusion criteria. The current meta-analysis indicated that there were no significant differences in the Lysholm knee function score (mean difference [MD] = −0.99, 95% confidence interval [CI]: −5.51 to 3.54, P = .67), Tegner activity scale (MD = 0.46, 95% CI: 0.03 to 0.90, P = .04), postoperative objective IKDCS (odds ratio [OR] = 1.66, 95% CI: 0.77 to 3.58, P = .20), postoperative subjective IKDCS (MD = 3.00, 95% CI: −0.29 to 6.29, P = .07), or knee posterior stability (MD = −0.45, 95% CI: −1.28 to 0.38, P = .29) between patients who received autograft tendons and those who received allograft tendons. The patients with autograft tendons had a higher Tegner activity scale (MD = 0.46, 95% CI: 0.03 to 0.90, P = .04) than those with allograft tendons.Conclusions:The present meta-analysis shows that there was insufficient evidence to indicate that allograft tendons were significantly better than autograft tendons for PCL reconstruction. Due to the limited quality and data in the studies currently available, in the future, more high-quality RCTs are required to answer this question more definitively.

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Section: Discussionmentioning

confidence: 99%

Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Tian

Hu²,

et al. 2017

Medicine

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“…As a result, many centres routinely perform reconstructions of the PCL. Based on the initial diagnosis and associated structures, different surgical techniques and different grafts are used [3-12]. With surgical treatment, good clinical results and improved subjective patient outcomes can be achieved [13-17].…”

Section: Introductionmentioning

confidence: 99%

Occupational consequences after isolated reconstruction of the insufficient posterior cruciate ligament

Ihle

Ateschrang

Albrecht³

et al. 2014

BMC Res Notes

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BackgroundWith incorrect or even without treatment, acute injuries of the posterior cruciate ligament (PCL) can lead to chronic instability of the knee joint. After delayed treatment, negative occupational changes and reduced quality of life can occur. These aspects have not yet been investigated. The purpose of this study was to evaluate occupational consequences after isolated reconstruction in cases of chronic PCL insufficiency.Findings12 patients treated with PCL reconstruction in a single bundle technique, using hamstring tendon grafts, were evaluated. All patients were operated upon at least 3 months after injury. Mean time of follow-up was 51 ± 18.2 months (14–75). Radiological assessment (Telos stress device) showed a side comparison of total translation of 4.5 ± 2.6 mm. Occupational consequences have been evaluated by the classification system “REFA”. Median time incapacity for work was 8 weeks. Nearly all patients achieved the mental status of the normal population (SF-36), but physical status was still restricted. A pre- to postoperative improvement of the clinical scores could be seen: Lysholm-Score: 46.4 ± 17.3 to 84.7 ± 14.1, HSS-Score: 74.3 ± 10.5 to 88.3 ± 10.7. Postoperative evaluated scores were: Tegner score: 4.8 ± 1.2, IKDC score: 80.0 ± 16.2, VPS: 3.4 ± 2.7. Patients with low physical load in their workplace described significantly better clinical results in every clinical score (p < .05) and less pain than patients with high physical load prior to the accident (VPS: REFA < 2: 2.4 ± 2.6, REFA ≥ 2: 5.5 ± 1.7; p < 0.05).ConclusionsOperative treated patients with a chronic PCL insufficiency achieve an improvement of the clinical result. Patients with low physical load at their workplace achieve less restrictions.

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“…[7][8][9] A number of evidence-based systematic reviews have attempted to determine the optimal technique for PCL reconstruction, but their findings are inconclusive. [10][11][12][13][14] The aim of the present evidence-based systematic review was to perform a meta-analysis to compare clinical and functional outcomes of PCL reconstruction using single-and double bundle techniques. Our hypothesis was that double bundle PCL reconstruction provides better restoration of normal knee motion than the single bundle technique, with consequent improvements in clinical outcome measurements.…”

Section: Introductionmentioning

confidence: 99%

Outcome of posterior cruciate ligament reconstruction using the single- versus double bundle technique: A meta-analysis

et al. 2015

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Objective: To test the hypothesis that double bundle posterior cruciate ligament (PCL) reconstruction yields better improvement in stability and functional recovery of the knee than the single bundle technique. Methods: PubMed Õ , Embase Õ , the Cochrane Library, CNKI, Wanfang and CBM disc databases were searched for comparative trials of PCL reconstruction using the single-versus double bundle technique. Data were extracted and meta-analysis was performed for stability improvement and functional recovery. Results: The meta-analysis included 435 patients in three randomized controlled trials (RCTs) and eight non-RCTs. Double bundle reconstruction provided significantly better 90 posterior stability than the single bundle technique (weighted mean difference 0.81, 95% confidence interval, [CI] 0.2, 1.42). Double bundle reconstruction resulted in a significantly higher likelihood of International Knee Documentation Committee (IKDC) examination grade A than the single bundle technique (odds ratio 0.41, 95% CI 0.24, 0.72). Conclusions: The small amount of data available indicates that double bundle reconstruction is superior to the single bundle technique after isolated PCL injury. These findings should be interpreted with caution due to the low quality and limited sample size of the studies concerned.

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Allograft Versus Autograft in Posterior Cruciate Ligament Reconstruction: An Evidence-Based Systematic Review

Cited by 50 publications

References 29 publications

Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Occupational consequences after isolated reconstruction of the insufficient posterior cruciate ligament

Outcome of posterior cruciate ligament reconstruction using the single- versus double bundle technique: A meta-analysis

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