Arthroscopic Reconstruction of the Anterior Cruciate Ligament With Hamstring Tendon Autograft and Fresh-Frozen Allograft

Kim, Sun; Zhang, Jihua; Wang, Yan; Xia, Changsuo; Zhang, Cailong; Yu, Tengbo; Tian, Shaoqi

doi:10.1177/0363546511400384

Cited by 89 publications

(123 citation statements)

References 36 publications

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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%

“…Similarly, within each study, postoperative rehabilitation was consistent for every patient. Five studies compared BPTB grafts [38-40, 42, 43], while two compared hamstring grafts [41,45]; one compared hamstring autograft with anterior tibialis allograft [46] and one compared hamstring autograft with free tendon Achilles allograft [44]. Six of the nine eligible studies did report the use of non-irradiated allografts [39-42, 45, 46].…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

“…Seven studies used fresh-frozen allografts [38-40, 42, 44-46]; one study used both cryopreserved and fresh-frozen allografts [41]; and one study did not report the storage method [43]. All five prospective cohort studies were high-quality [38][39][40][41]43], while none of the four randomized controlled trials was high-quality [42,[44][45][46] (Table 1).…”

Section: Study Characteristics and Qualitymentioning

confidence: 99%

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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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Section: Literature Searchmentioning

confidence: 99%

Section: Study Characteristics and Qualitymentioning

confidence: 99%

Section: Study Characteristics and Qualitymentioning

confidence: 99%

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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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“…Although Gamma irradiation is known for its bactericidal and virucidal properties, a meta-analysis has shown that even a small dose of about 2 Mrad can cause about 31% abnormal laxity in ligaments reconstructed with irradiated allografts, because of alteraltion in biomechanical properties which is significantly high when compared to non-irradiated grafts which is around 12%. 12,13 Hence, all the grafts we used were maintained as fresh frozen but not irradiated. This procedure helps reduce antigenicity and disease transmission without affecting the graft strength.…”

Section: Discussionmentioning

confidence: 99%

Soft tissue allograft for primary anterior cruciate ligament reconstruction

et al. 2017

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Background: Arthroscopic ACL reconstruction has become one of the most commonly performed arthroscopic surgeries. Inspite of extensive research on available autograft options, controversy still persists regarding the ideal graft. Allograft tendons usage in orthopedic operations has increased because of its advantages. This study was conducted to assess the functional outcome in patients undergoing ACL reconstruction with soft tissue allografts.Methods: 15 patients with Anterior Cruciate Ligament injury presenting from 2012-2014 who underwent Arthroscopic ACL reconstruction with soft tissue allograft were the subjects of this Prospective study. Assessment of the involved knee was performed to obtain subjective measures of the clinical outcomes of the ACL reconstruction. All patients were followed up at regular intervals of 3 weeks, 6 weeks, 12 weeks, 6 months and 2 years.Results: At the final follow up, the patients had an average Lysholm knee score of 85.60, Tegner score of 7.24 and IKDC score of 85.28. Knee flexion of >1200 was achieved in >80% of patients and minimal laxity in 60% patients but no functional disability in any of them. No graft failures were noted. Conclusions: Contrary to the fear of graft failure and complications associated with allograft construct for primary ACL reconstruction, allografts yield the same clinical outcome as autografts with the advantages of reduced operative time, no donor site morbidity, preservation of native hamstring tendons, faster and comfortable rehabilitation. Allografts are a good alternative to autografts for primary ACL reconstruction.

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“…Some randomized controlled and prospective trials have verified that both autografts and allografts showed satisfactory and comparable outcomes 4 . But the utilization of the allograft in ACL reconstruction also raises a series of problems such as sterilization and preservation of the allograft, disease transmission, the immune response to the allograft tissue by the host, and delayed graft incorporation, which will affect the biomechanical properties and clinical outcomes of allografts.…”

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confidence: 97%

Tibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft

Zhang

Hao

et al. 2017

Acta Cir. Bras.

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IVTibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft 1 Abstract Purpose: To investigate tibial tunnel widening and knee instability after ACL reconstruction with hamstring autograft or irradiated soft tissue allograft. Methods: Eight-two patients were divided into two groups: autograft group and allograft group. Radiographic and clinical evaluations were performed. Results: Seventy patients were followed up with median of 36.3 months (range 36-38 months). Tibial tunnel widening was at or greater than 30% for nine patients in the autograft group and 15 patients in the allograft group (P = 0.0417). The average percentage of tibial tunnel widening was 26.7 ± 4.0 % and 29.7 ± 5.3 % in autograft and allograft groups, respectively (P = 0.0090). Knee range of motion was not affected by the reconstruction operation or different grafts. Thigh atrophy improved significantly within 24 months after ACL reconstructions in both groups. ACL reconstruction with the allograft leaded to less knee stability than that with the autograft from one year after operation (P = 0.0023). There was no significant difference between two groups with respect to Lysholm score (P = 0.1925) and Tegner score (P =0 .0918) at the final follow-up. Conclusion:The allograft group reported significantly more tibial tunnel widening and knee instability compared with the autograft group.

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Arthroscopic Reconstruction of the Anterior Cruciate Ligament With Hamstring Tendon Autograft and Fresh-Frozen Allograft

Abstract: Both groups of patients achieved almost the same satisfactory outcome at an average of 7.8 years of follow-up. Fresh-frozen hamstring tendon allograft is a reasonable alternative choice to autograft for anterior cruciate ligament reconstruction.

Cited by 89 publications

References 36 publications

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

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

Soft tissue allograft for primary anterior cruciate ligament reconstruction

Tibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft

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