Analysis of Outcomes of Anterior Cruciate Ligament Repair With 5-Year Follow-up: Allograft Versus Autograft

Poehling, Gary G.; Curl, Walton W.; Lee, Cassandra A.; Ginn, T. Adam; Rushing, Julia; Naughton, Michelle J.; Holden, Martha B.; Martín, David; Smith, Beth Paterson

doi:10.1016/j.arthro.2005.04.112

Cited by 163 publications

(109 citation statements)

References 33 publications

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“…Many factors during and after surgery can influence the knee stability: the surgical approaches, fixation methods, bone-to-bone versus tendonto-bone healing, and postoperative rehabilitation. To reduce these confounding variables, this meta-analysis only pooled these studies that the surgical approaches, fixation methods and postoperative rehabilitation were consistent within each individual study, and excluded those studies comparing BPTB graft with soft-tissue graft [36]. In this metaanalysis, no significant difference could be found between autografts and allografts, regarding to the instrumented laxity measurements, Lachman test and Pivot Shift test.…”

Section: Discussionmentioning

confidence: 83%

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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: Discussionmentioning

confidence: 83%

“…Three studies were excluded because of not a minimum two-year follow-up study [33][34][35]. One study was excluded because it compared BPTB autograft with soft-tissue allograft [36]. One study was excluded because of involving irradiated allografts [37].…”

Section: Literature Searchmentioning

confidence: 99%

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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“…10 Among the studies that reported use of objective criteria for return-to-sport decision making, the most commonly used assessments were strength testing, performance-based functional testing, and self-reported knee function; although specific criterion values varied widely among studies. 10,23 Strength tests of the quadriceps and hamstrings 10,11,[15][16][17][18]26,41,47,59,60 and the single-leg hop test 1,10,25 are among the most commonly used to objectively determine patient readiness for return to sports after ACL reconstruction and are associated with several indicators of return-to-sport success. Typically, limb symmetry indices (LSIs) are used to assess whether muscle strength and functional performance are restored after ACL reconstruction compared to the uninvolved limb.…”

Section: U U Conclusionmentioning

confidence: 99%

Young Athletes After Anterior Cruciate Ligament Reconstruction Cleared for Sports Participation: How Many Actually Meet Recommended Return-to-Sport Criteria Cutoffs?

Toole

Ithurburn

Rauh

et al. 2017

J Orthop Sports Phys Ther

106

165

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Rupture of the anterior cruciate ligament (ACL) is a devastating injury that occurs with high frequency among individuals who participate in cutting and pivoting sports. 24,48 Anterior cruciate ligament reconstruction is commonly performed with the goal of facilitating return to sports activities. However, recent metaanalysis data from over 7000 participants following ACL reconstruction demonstrated that 65% returned to their previous level of sport and only 55% returned to competitive sports.3 Factors associated with a higher rate of return to preinjury level of sport participation were younger age, male sex, positive psychological U U STUDY DESIGN: Prospective cohort study. U U BACKGROUND: While meeting objective criterion cutoffs is recommended prior to return to sports following anterior cruciate ligament (ACL) reconstruction, the number of young athletes who meet recommended cutoffs and the impact of cutoffs on longitudinal sports participation are unknown. U U OBJECTIVES:To test the hypothesis that a higher proportion of young athletes who meet recommended cutoffs will maintain the same level of sports participation over the year following return-to-sport clearance compared to those who do not meet recommended cutoffs. U U METHODS:At the time of return-to-sport clearance, the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), quadriceps and hamstring strength limb symmetry index (LSI), and single-leg hop test LSI were assessed. Proportions of participants who met individual (IKDC score of 90 or greater; strength and hop test LSIs of 90% or greater) and combined cutoffs were calculated. Proportions of participants who continued at the same level of sports participation over the year following returnto-sport clearance (assessed using the Tegner activity scale) were compared between those who met and did not meet cutoffs. U U RESULTS:Participants included 115 young athletes (88 female). The proportions meeting individual cutoffs ranged from 43.5% to 78.3%. The proportions meeting cutoffs for all hop tests, all strength tests, and all combined measures were 53.0%, 27.8%, and 13.9%, respectively. A higher proportion of participants who met cutoffs for both strength tests maintained the same level of sports participation over the year following return-tosport clearance than those who did not (81.3% versus 60.2%, P = .02). U U CONCLUSION:The proportions of young athletes after ACL reconstruction recently cleared for return to sports who met the combined criterion cutoffs were low. Those who met the criterion cutoffs for both strength tests maintained the same level of sports participation at higher proportions than those who did not. U U LEVEL OF EVIDENCE: Prognosis, level 2b.

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“…Achilles tendon allografts have shown to be effective in anterior cruciate ligament (ACL) reconstruction with similar functional outcomes compared to autografts. (Poehling et al, 2005;Indelli et al, 2004). The use of Achilles tendon allograft for reconstruction of the neglected Achilles ruptures have been reported but mostly limited to case reports (Nellas et al, 1996;Yuen & Nicholas, 2000;Lepow & Green, 2006).…”

Section: Achilles Tendon Allograftmentioning

confidence: 99%

Surgical Treatment of the Neglected Achilles Tendon Rupture

Lee¹,

Schuberth²

2012

Achilles Tendon

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Analysis of Outcomes of Anterior Cruciate Ligament Repair With 5-Year Follow-up: Allograft Versus Autograft

Cited by 163 publications

References 33 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

Young Athletes After Anterior Cruciate Ligament Reconstruction Cleared for Sports Participation: How Many Actually Meet Recommended Return-to-Sport Criteria Cutoffs?

Surgical Treatment of the Neglected Achilles Tendon Rupture

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