Clinical Outcomes of Allograft Versus Autograft in Anterior Cruciate Ligament Reconstruction

Baer, Geoffrey S.; Harner, Christopher D.

doi:10.1016/j.csm.2007.06.010

Cited by 141 publications

(107 citation statements)

References 95 publications

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“…Our survey findings showed that about 11 % of the surgeons prefer allograft over autograft, a rate that is similar to previous reports [3,9]. A meta-analysis that included six randomized controlled trials with 534 patients compared BPTB autografts and allografts [16].…”

Section: Graft Choicesupporting

confidence: 74%

“…Most surgeons reportedly prefer autograft over allograft for ACL reconstruction: the use of allograft for ACL reconstruction has gained increasing popularity and is now estimated to be used in 20-30 % of primary reconstructions in the USA [3,9]. Although they are associated with no harvest site morbidity, and provide predictable graft size, shorter operative time and easier recovery in the postoperative period, allografts are considered more likely to fail because of decreased mechanical properties due to sterilization and the possibility of triggering an inflammatory response [3,9]. Furthermore, some patients refuse to consent to their use because of the risks of disease transmission or psychological factors [3,9,16].…”

Section: Graft Choicementioning

confidence: 99%

“…Historically, ACL reconstructions were performed using bone-patellar-tendon-bone (BPTB) autografts fixed with metal interference screws (IS). BPTB autografts have been considered the gold standard to which other technologies are compared [3,20,23]. The goals of ACL reconstruction are to restore knee stability, prevent further damage to knee structures and improve functional outcome.…”

Section: Introductionmentioning

confidence: 99%

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An international survey on anterior cruciate ligament reconstruction practices

Chechik

Amar

Khashan

et al. 2012

International Orthopaedics (SICOT)

167

134

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Purpose Bone-patellar-tendon-bone (BPTB) autografting fixed with metal interference screws (IS) is the gold standard for anterior cruciate ligament (ACL) reconstruction. Advances in surgical technology provide a wide choice of grafts, fixation devices and surgical approaches. Methods Two-hundred and sixty-one orthopedic surgeons of ten subspecialties from 57 countries were surveyed on their choice of graft and fixation device, the number of reconstructed bundles, and arthroscopic portal. Their preferences were analyzed according to country of origin, field of expertise and seniority, and compared to current publications. Results Hamstring autografting was the most popular choice (63 %), then BPTB (26 %) and allograft (11 %). The anteromedial portal was preferred over the traditional transtibial portal (68 % versus 31 %). Two-thirds reported routinely performing a single-bundle graft reconstruction, compared to one-third who used the double-bundle technique. The Endo-button was the most common graft fixation method (40 %), followed by the bioabsorbable IS (34 %), metallic IS (12 %), rigidfix (10 %) and others (4 %). The preferences of hamstring tendon grafting and the anteromedial portal are not supported in the literature. Responses from North American and European surgeons were different from all the others.Conclusions Surgeon preferences in ACL reconstruction differ considerably worldwide. Common practice is not always supported by evidence-based publications.

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Section: Graft Choicesupporting

confidence: 74%

Section: Graft Choicementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An international survey on anterior cruciate ligament reconstruction practices

Chechik

Amar

Khashan

et al. 2012

International Orthopaedics (SICOT)

167

134

View full text Add to dashboard Cite

show abstract

“…Allografts have recently gained popularity in orthopaedic sports medicine, especially in primary and revision reconstruction of the anterior cruciate ligament (ACL) [2]. Allografts eliminate harvest morbidity and reportedly allow faster rehabilitation, earlier return to full activity, and possible cost reduction [4,10,25].…”

Section: Introductionmentioning

confidence: 99%

Remodeling of ACL Allografts is Inhibited by Peracetic Acid Sterilization

Scheffler

Gonnermann

Kamp

et al. 2008

Clin Orthop Relat Res

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Sterilization of allografts for anterior cruciate ligament (ACL) reconstruction has become an important prerequisite to prevent disease transmission. However, current sterilization techniques impair the biological or mechanical properties of such treated grafts. Peracetic acid (PAA) has been successfully used to sterilize bone allografts without these disadvantages and does not impair the mechanical properties of soft tissue grafts in vitro. We asked whether PAA sterilization would influence recellularization, restoration of crimp length and pattern, and revascularization of ACL grafts during early healing. We used an in vivo sheep model for open ACL reconstruction. We also correlated the histologic findings with the restoration of anteroposterior stability and structural properties during load-to-failure testing. PAA slowed remodeling activity at 6 and 12 weeks compared to nonsterilized allografts and autografts. The mechanical properties of PAA grafts were also reduced compared to these control groups at both time points. We conclude PAA sterilization currently should not be used to sterilize soft tissue grafts typically used in ACL reconstruction.

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“…In the U.S, ACL injury rate is almost 1 in 3500 individuals every year [1] which is calculated to approximately 125000 to 200000 ACL reconstructions yearly. Many studies have examined the injury rate in football and they reported that from all injuries, 60% to 80% occur in lower extremities [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Return to Sport after Anterior Cruciate Ligament Reconstruction: A Literature Review

P¹

2014

J Nov Physiother

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Clinical Outcomes of Allograft Versus Autograft in Anterior Cruciate Ligament Reconstruction

Cited by 141 publications

References 95 publications

An international survey on anterior cruciate ligament reconstruction practices

An international survey on anterior cruciate ligament reconstruction practices

Remodeling of ACL Allografts is Inhibited by Peracetic Acid Sterilization

Return to Sport after Anterior Cruciate Ligament Reconstruction: A Literature Review

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