Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction

Peterson, Robert K. D.; Shelton, Walter R.; Bomboy, Anna Laura

doi:10.1053/jars.2001.19965

Cited by 195 publications

(189 citation statements)

References 12 publications

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“…As several studies (Harner et al, 1996;Shelton et al, 1997;Peterson et al, 2001;Rihn et al, 2006) reported, we found that individuals who had an autograft reconstruction had more significant numbness and dysesthesia in the area of the incision than individuals who underwent allograft reconstruction, but there was no difference in patient-reported kneeling problems.…”

Section: Discussionsupporting

confidence: 49%

ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft

Kim

Tian

Zhang

et al. 2009

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To analyze the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with irradiated bone-patellar tendon-bone (BPTB) allograft compared with non-irradiated allograft and autograft. Methods: All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution. A total of 68 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into one of the two groups (autograft and irradiated allograft groups). The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months of follow-up (ranging from 24 to 47 months), patients were evaluated by the same observer according to objective and subjective clinical evaluations. Results: Of these patients, 65 (autograft 33, irradiated allograft 32) were available for full evaluation. When the irradiated allograft group was compared to the autograft group at the 31-month follow-up by the Lachman test, the anterior drawer test (ADT), the pivot shift test, and KT-2000 arthrometer test, statistically significant differences were found. Most importantly, 87.8% of patients in the autograft group and just only 31.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft (34.4%) was higher than that with autograft (6.1%). The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Documentation Committee (IKDC), functional and subjective evaluations, and activity level testing, no statistically significant differences were found between the two groups. Besides, patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever. When the patients had a fever, the laboratory examinations of all patients were almost normal. Blood routine was normal, the values of erythrocyte sedimentation rate (ESR) were 5~16 mm/h and the contents of C reactive protein (CRP) were 3~10 mg/L. Conclusion: We conclude that the short term clinical outcomes of the ACL reconstruction with irradiated BPTB allograft were adversely affected. The less than satisfactory results led the senior authors to discontinue the use of irradiated BPTB allograft in ACL surgery and not to advocate using the gamma irradiation as a secondary sterilizing method.

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Section: Discussionsupporting

confidence: 49%

ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft

Kim

Tian

Zhang

et al. 2009

J. Zhejiang Univ. Sci. B

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“…One study was excluded because of involving irradiated allografts [37]. Therefore, nine studies, with 410 patients in the autograft and 408 patients in the allograft group, were determined to be appropriate for this meta-analysis [38][39][40][41][42][43][44][45][46] (Table 1).…”

Section: Literature Searchmentioning

confidence: 99%

Allograft versus autograft for anterior cruciate ligament reconstruction: an up-to-date meta-analysis of prospective studies

et al. 2012

International Orthopaedics (SICOT)

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Purpose Although a large number of anterior cruciate ligament (ACL) reconstructions are performed annually, there remains a considerable amount of controversy over whether an autograft or an allograft should be used. The aim of this meta-analysis was to compare the clinical outcomes of allograft and autograft in primary ACL reconstruction. Methods The authors systematically searched electronic databases to identify prospective studies which compared allografts with autografts for primary ACL reconstruction. The results of the eligible studies were analysed in terms of instrumented laxity measurements, Lachman test, Pivot Shift test, objective International Knee Documentation Committee (IKDC) Scores, Lysholm Scores, Tegner Scores, and clinical failures. Study quality was assessed and relevant data were extracted independently by two reviewers. A random effect model was used to pool the data. Statistical heterogeneity between trials was evaluated by the chi-square and I-square tests. Results Nine studies, with 410 patients in the autograft and 408 patients in the allograft group, met the inclusion criteria. Five studies compared bone-patellar tendon-bone (BPTB) grafts, and four compared soft-tissue grafts. Four studies were randomized controlled trials, and five were prospective cohort studies. The results of the meta-analysis showed that there were no significant differences between allograft and autograft on all the outcomes in terms of instrumented laxity measurements (P 00.59), Lachman test (P 00.41), Pivot

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“…Since the decision is absolutely in accordance with the patient's preference, the two groups in our study were eligible for retrospective clinical assessment. Comparative studies focusing on the late functional and subjective results in BTB autografting and allografting are relatively rare [11,14,15,19]. We examined 79 patients with an average follow-up of 35 months and found no significant differences between the two groups regarding functional and subjective satisfaction level.…”

Section: Symptomsmentioning

confidence: 89%

“…In the last decade, several reports have discussed ACL reconstruction, yet comparison between BTB grafts of different origins (allografts or autografts) are scarcely available in the literature [11,14,15,19]. We report here a comparative study of primary ACL reconstructions using either autogenous or allogeneic BTB grafts.…”

Section: Introductionmentioning

confidence: 99%