Arthroscopic posterior cruciate ligament reconstruction with allograft versus autograft

Abstract

IntroductionThe aim of the study was to compare and analyze retrospectively the outcomes of arthroscopic posterior cruciate ligament reconstruction with autograft versus allograft.Material and methodsSeventy-one patients who underwent arthroscopic posterior cruciate ligament reconstruction with an autograft or allograft met our inclusion criteria. There were 36 patients in the autograft group and 35 patients in the allograft group. All the patients were evaluated by physical examination and a functional ligament test. Comparative analysis was done in terms of operation time, incision length, fever time, postoperative infection rate, incidence of numbness and dysesthesia around the incision, as well as a routine blood test.ResultsThe average follow-up of the autograft group was 3.2 ±0.2 years and that of the allograft group was 3.3 ±0.6 years; there was no significant difference (p > 0.05). No differences existed in knee range of motion, Lysholm scores, International Knee Documentation Committee standard evaluation form and Tegner activity score at final follow-up (p > 0.05), except that patients in the allograft group had a shorter operation time and incision length and a longer fever time (p < 0.05). We found a difference in posterior drawer test and KT-2000 arthrometer assessment (p < 0.05). The posterior tibia displacement averaged 3.8 ±1.5 mm in the autograft group and 4.8 ±1.7 mm in the allograft group (p < 0.05). The incidence of numbness and dysesthesia around the incision in the autograft group was higher than that in the allograft group (p < 0.05). There was no infection postoperatively. The white blood cells and neutrophils in the allograft group increased more than those in the autograft group postoperatively (p < 0.05).ConclusionsBoth groups of patients had satisfactory outcomes after the operation. However, in the instrumented posterior laxity test, the autograft gave better results than the allograft. No differences in functional scores were found.

Autograft Versus Allograft for Posterior Cruciate Ligament Reconstruction: An Updated Systematic Review and Meta-analysis

“…Li et al 17 randomized patients to autograft or allograft. Two studies 16,24 selected graft type based on patient preference. Kim et al 13 performed PCLR with a bone–patellar tendon–bone (BPTB) autograft except in cases of patellofemoral joint disease, patellofemoral maltracking, narrow width of the patellar tendon (<30 mm wide), or poor skin condition.…”

“…Li et al 16 found no significant differences between groups with regard to age at surgery, BMI, or duration from injury to surgery. Sun et al 24 found no differences between groups with regard to sex, age, duration of injury (acute vs chronic), or the proportion of patients with an intraoperative finding of a meniscal injury, cartilage lesion, or medial collateral ligament (MCL) injury. Ahn et al 1 found no differences between groups with regard to age, sex, activity level, or duration from injury to surgery.…”

“…A systematic review from 2013 6 found that the data on autograft versus allograft use for PCLR are scarce, but given the limited data, no significant differences in clinical outcomes could be established. Several studies 16,17,24 have been published since that review comparing autograft versus allograft use for PCLR. The purpose of this study is to provide an updated systematic review of the literature comparing the clinical outcomes of PCLR with autograft versus allograft.…”

Allografts in reconstruction of the posterior cruciate ligament: a health economics perspective

“…Tian et al [ 22 ] provide a meta-analysis of autograft and allografts in PCL reconstruction but include only five studies, the RCT by Li et al [ 12 ], and CCTs by Ahn et al [ 1 ], Li et al [ 11 ], Sun et al [ 21 ] and Wang et al [ 23 ], some of which we would exclude. Ahn et al [ 1 ] had only 18 patients in each group.…”

“…Six prospective studies of allografts in posterior cruciate ligament (PCL) reconstruction [ 13 – 15 , 20 , 26 , 27 ] were included. Two studies [ 12 , 21 ] were excluded because grafts were irradiated. There was a range of study designs, with two RCTs of allograft options, one RCT comparing allografts and autografts, two CCTs and four single-arm before and after studies.…”