Bone–Patellar Tendon–Bone Versus Soft-Tissue Allograft for Anterior Cruciate Ligament Reconstruction: A Systematic Review

Joyce, Christopher D.; Randall, Kyle; Mariscalco, Michael W.; Magnussen, Robert A.; Flanigan, David C.

doi:10.1016/j.arthro.2015.08.003

Cited by 15 publications

(14 citation statements)

References 35 publications

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“…Gold standard treatment for ACL reconstruction is the use of autograft or allograft tissues . The surgical use of autograft has limitations including donor site morbidity, leading to the increasing use of allografts . Allografts are however associated with prolonged periods of incorporation due to the presence of cellular components .…”

Section: Introductionmentioning

confidence: 99%

“…3 The surgical use of autograft has limitations including donor site morbidity, 4 leading to the increasing use of allografts. 5 Allografts are however associated with prolonged periods of incorporation due to the presence of cellular components. 6 A promising alternative is the use of acellular allogeneic or xenogeneic tendon or ligament tissue for ACL reconstruction.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effects of irradiation on the biological and biomechanical properties of an acellular porcine superflexor tendon graft for cruciate ligament repair

et al. 2016

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Acellular xenogeneic tissues have the potential to provide ‘off‐the‐shelf’ grafts for anterior cruciate ligament (ACL) repair. To ensure that such grafts are sterile following packaging, it is desirable to use terminal sterilization methods. Here, the effects of gamma and electron beam irradiation on the biological and biomechanical properties of a previously developed acellular porcine superflexor tendon (pSFT) were investigated. Irradiation following treatment with peracetic acid was compared to peracetic acid treatment alone and the stability of grafts following long‐term storage assessed. Irradiation did not affect total collagen content or biocompatibility (determined using a contact cytotoxicity assay) of the grafts, but slightly increased the amount of denatured collagen in and decreased the thermal denaturation temperature of the tissue in a dose dependant fashion. Biomechanical properties of the grafts were altered by irradiation (reduced ultimate tensile strength and Young's modulus, increased failure strain), but remained superior to reported properties of the native human ACL. Long term storage at 4°C had no negative effects on the grafts. Of all the conditions tested, a dose of minimum 25 kGy of gamma irradiation had least effect on the grafts, suggesting that this dose produces a biocompatible pSFT graft with adequate mechanical properties for ACL repair. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2477–2486, 2017.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effects of irradiation on the biological and biomechanical properties of an acellular porcine superflexor tendon graft for cruciate ligament repair

et al. 2016

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“…showed that the overall stability rate was 72% for all autografts compared with 59% for all allografts ( P < 0.001), which did not account for the effect of irradiation on the allograft tissue. Christopher et al . and Mariscalco et al .…”

Section: Introductionmentioning

confidence: 99%

“…The use of allografts has increased in recent years because they offer less donor‐site morbidity, shorter surgical and anesthesia times, fewer postoperative complications, faster postoperative recovery, lower incidence of postoperative arthrofibrosis, less postoperative pain, and an unlimited graft source in the setting of multi‐ligament and revision reconstructions. However, allografts are associated with a higher expense, a risk of disease transmission, delayed healing, ligamentization, and an increased risk of graft rupture in the younger, more active population.…”

Section: Introductionmentioning

confidence: 99%

Autografts vs Synthetics for Cruciate Ligament Reconstruction: A Systematic Review and Meta‐Analysis

Sun

Wei

et al. 2020

Orthopaedic Surgery

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To describe the outcomes of autografts and synthetics in anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction with respect to instrumented laxity measurements, patient-reported outcome scores, complications, and graft failure risk. We searched PubMed, Cochrane Library, and EMBASE for published randomized controlled trials (RCT) and case controlled trials (CCTs) to compare the outcomes of the autografts versus synthetics after cruciate ligament reconstruction. Data analyses were performed using Cochrane Collaboration RevMan 5.0. Nine studies were identified from the literature review. Of these studies, three studies compared the results of bonepatellar tendon-bone (BPTB) and ligament augmentation and reconstruction system (LARS), while six studies compared the results of four-strand hamstring tendon graft (4SHG) and LARS. The comparative study showed no difference in Lysholm score and failure risk between autografts and synthetics. The combined results of the meta-analysis indicated that there was a significantly lower rate of side-to-side difference > 3 mm (Odds Ratio [OR] 2.46, 95% confidence intervals [CI] 1.44-4.22, P = 0.001), overall IKDC (OR 0.40, 95% CI 0.19-0.83, P = 0.01), complications (OR 2.54, 95% CI 1.26-5.14, P = 0.009), and Tegner score (OR −0.31, 95% CI −0.52-0.10, P = 0.004) in the synthetics group than in the autografts group. This systematic review comparing long-term outcomes after cruciate ligament reconstruction with either autograft or synthetics suggests no significant differences in failure risk. Autografts were inferior to synthetics with respect to restoring knee joint stability and patient-reported outcome scores, and were also associated with more postoperative complications.

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“…The choice of the graft depends on different patient's and surgeon's factors [8]. However, it was found that patellar tendon (PT) autografts produce a more statically stable knee [3] and less failure rate and risk of early revision than hamstrings tendons (HT) [9] [10].…”

Section: Introductionmentioning

confidence: 99%

Proximal Tibial Fracture after Bone-Patellar Tendon-Bone Autograft Harvesting in Anterior Crutiate Ligament Reconstruction: Literature Review and Report of Two Cases

Aldawoudy¹,

Elfatarany²,

Badr³

et al. 2018

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ACL reconstruction surgery shows low incidence of complications (1.38%) like DVT, Infection, patellar tendon rupture and fractures whether in the proximal tibia or the distal femur. We hereby present two cases that have had the rare complication of proximal tibial fracture. The circumstances of each case are discussed together with discussion of similar cases described in the literature. We tried in the end to have an idea about the possible causes and how to prevent such a devastating event. Case presentation: Case 1 shows a 38-year-old female patient who had an ACL reconstruction surgery by BTB graft followed by iatrogenic proximal tibial fracture managed by open reduction internal fixation by T plate and screws. Case 2 shows a 28-year-old male patient who had an ACL reconstruction surgery by BTB graft also followed by Proximal tibial fracture 3 weeks later managed by open reduction internal fixation using a locked plate and screws. Discussion: Fractures are a rare complication that may follow ACL reconstruction surgery. These fractures can be femoral or tibial that may be due to the reduction of the bone strength as a result of the drill holes which behave as a stress riser. We also suggest that usage of osteotomes during grafting plays a role in these fractures. Management of these fractures is either by open reduction and internal fixation or closed reduction. What is known about the subject: Patellar fractures are a known complication of ACL reconstruction using patellar tendon graft. What this study adds to the existing knowledge: Raising the Knowledge that also the tibia can be fractured as a complication of patellar tendon harvesting not only the patella.

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Bone–Patellar Tendon–Bone Versus Soft-Tissue Allograft for Anterior Cruciate Ligament Reconstruction: A Systematic Review

Cited by 15 publications

References 35 publications

The effects of irradiation on the biological and biomechanical properties of an acellular porcine superflexor tendon graft for cruciate ligament repair

The effects of irradiation on the biological and biomechanical properties of an acellular porcine superflexor tendon graft for cruciate ligament repair

Autografts vs Synthetics for Cruciate Ligament Reconstruction: A Systematic Review and Meta‐Analysis

Proximal Tibial Fracture after Bone-Patellar Tendon-Bone Autograft Harvesting in Anterior Crutiate Ligament Reconstruction: Literature Review and Report of Two Cases

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