Editorial Commentary: Autograft Beats Allograft for Most Knee Ligament Surgery

Therrien, Erik; Stuart, Michael J.; Levy, Bruce A.

doi:10.1016/j.arthro.2020.12.181

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…The elongation of the human dermal allograft may cause increased superior translation of the humeral head and abrasion of the graft under the acromion, resulting in pain or graft failure. Although allograft has advantages, such as no donor site morbidity and reduced operative time, it also has disadvantages with increased cost and higher failure rates [21, 46]. Furthermore, the graft healing rate did not seem as satisfactory as that in SCR using an autograft.…”

Section: Discussionmentioning

confidence: 99%

Superior capsular reconstruction using hybrid graft for irreparable massive rotator cuff tear

Yoon

Kim

Yoon

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate the clinical and radiological outcomes of arthroscopic superior capsular reconstruction (SCR) using hybrid grafts composed of tensor fascia lata autografts and human dermal allografts. Methods This study included 30 patients with chronic irreparable posterosuperior rotator cuf tears (RCTs) who underwent arthroscopic SCR using a hybrid graft composed of tensor fascia lata autograft and human dermal allograft. Clinical outcomes were evaluated using the pain visual analogue scale score, shoulder range of motion, American Shoulder and Elbow Surgeons score, constant score, University of California-Los Angeles score, and simple shoulder test score preoperatively and at least 2 years after surgery. Radiographic analysis included the Hamada classiication grade, acromiohumeral distance (AHD), and graft integrity at 2 years after surgery. Results All patients exhibited signiicant clinical improvement in all functional outcome measurements, except external rotation (all P < 0.05). The number of patients who exhibited pseudoparalysis decreased from 7 (23.3%) to 2 (6.7%) postoperatively. Complications were not observed. Radiologically, the mean postoperative AHD increased signiicantly from 6.9 ± 1.6 cm to 8.8 ± 2.1 cm at 2 years postoperatively (P < 0.001). Twenty ive out of the 30 (83.3%) patients showed successful graft healing, and all healing failures occurred on the humeral side. The diferences between the healed-graft and failed-graft groups were signiicantly lower graft thickness (P = 0.001) and smaller AHD (P < 0.001) in the failed-graft group. Every functional outcome scores were not statistically diferent between healed-graft and failed-graft groups. Conclusions An arthroscopic SCR technique using a hybrid graft consisting of a tensor fascia lata autograft and human dermal allograft showed satisfactory clinical outcomes in patients with irreparable RCTs. Level of evidence IV. KeywordsSuperior capsular reconstruction • Hybrid graft • Tensor fascia lata • Human dermal allograft • Irreparable massive rotator cuf tear * Seok Won Chung

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Section: Discussionmentioning

confidence: 99%

Superior capsular reconstruction using hybrid graft for irreparable massive rotator cuff tear

Yoon

Kim

Yoon

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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“…Although autograft use is linked to improved outcomes in primary and revision ACL reconstruction among younger, more active cohorts, 40 little to no difference in clinical outcomes has been found for ACL and PCL reconstruction with allograft versus autograft in the adult population overall. 41 , 42 Data comparing the use of autograft and allograft for reconstruction of other extra-articular knee structures such as the LCL and PLC are relatively sparse 43 ; thus, it remains unclear whether autograft and allograft perform differently when used to reconstruct the cruciate versus the collateral ligaments. Despite this, our sample reported high levels of satisfaction after receiving allograft reconstruction for MLKI, suggesting that this is a viable treatment option for patients aged 40 years and older.…”

Section: Discussionmentioning

confidence: 99%

High Levels of Satisfaction and Adequate Patient-Reported Outcomes After Operative Reconstruction of Multiligament Knee Injury With Allograft Among Patients Aged 40 Years and Older

Toppo¹,

Perrone²,

Sylvia³

et al. 2023

Arthroscopy, Sports Medicine, and Rehabilitation

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“…A variety of PCLR techniques have been described using autograft versus allograft, 16 , 41 single versus double bundle, 31 and open inlay versus arthroscopic transtibial. 27 Although data directly comparing each of these techniques are sparse, reported clinical outcomes have demonstrated no significant differences.…”

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confidence: 99%

Comparison of Posterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement

Therrien

Pareek

Song

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Biomechanical studies support the use of suture tape reinforcement for limiting graft elongation and increasing strength in knee ligament reconstructions. Purpose: To compare posterior cruciate ligament (PCL) laxity, complication and reoperation rates, and patient-reported outcomes (PROs) after all-inside single-bundle PCL reconstruction (PCLR) with versus without independent suture tape reinforcement. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective cohort study of consecutive patients who underwent primary, all-inside allograft single-bundle PCLR with and without independent suture tape reinforcement at a single academic institution from 2012 to 2019. Medical records were reviewed for patient characteristics, additional injuries, and concomitant procedures. PRO scores (including the International Knee Documentation Committee [IKDC], Tegner activity scale, and Lysholm scores), bilateral comparison kneeling radiographs, and physical examination findings were collected at a minimum of 2 years postoperatively. Results: Included were 50 patients: 19 with suture tape reinforcement (mean age 30.6 ± 2.9 years) and 31 without suture tape reinforcement (control group; mean age 26.2 ± 1.6 years). One PCLR graft in the suture tape group failed. Posterior drawer examination revealed grade 1+ laxity in 4 of 19 (21%) of the suture tape cohort versus 6 of 31 (19%) of the control cohort ( P > .999). Bilateral kneeling radiographs showed similar side-to-side differences in laxity between the groups (suture tape vs control: mean, 1.9 ± 0.4 vs 2.6 ± 0.6 mm; P = .361). There were no statistically significant differences between the groups in postoperative IKDC (suture tape vs control: 79.3 vs 79.6; P = .779), Lysholm (87.5 vs 84.3; P = .828), or Tegner activity (5.6 vs 5.7; P = .562) scores. Conclusion: All-inside single-bundle PCLR with and without independent suture tape reinforcement demonstrated low rates of graft failure, complications, and reoperations, with satisfactory PROs at a minimum 2-year follow-up. Radiographic posterior tibial translation was comparable between the 2 groups.

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Editorial Commentary: Autograft Beats Allograft for Most Knee Ligament Surgery

Cited by 4 publications

References 15 publications

Superior capsular reconstruction using hybrid graft for irreparable massive rotator cuff tear

Superior capsular reconstruction using hybrid graft for irreparable massive rotator cuff tear

High Levels of Satisfaction and Adequate Patient-Reported Outcomes After Operative Reconstruction of Multiligament Knee Injury With Allograft Among Patients Aged 40 Years and Older

Comparison of Posterior Cruciate Ligament Reconstruction Using an All-Inside Technique With and Without Independent Suture Tape Reinforcement

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