Autograft Versus Allograft Anterior Cruciate Ligament Reconstruction

Bottoni, Craig R.; Smith, Eric L.; Shaha, James S.; Shaha, Steven H.; Raybin, Sarah G.; Tokish, John M.; Rowles, Douglas J.

doi:10.1177/0363546515596406

Cited by 147 publications

(80 citation statements)

References 64 publications

(65 reference statements)

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“…The general approach in surgery for the incapacity created by these ligament injuries is intra-articular anatomic reconstruction of the ligaments rather than primary repair. However, there is as yet no consensus on subjects such as graft selection, placement, and fixation in both ACL and PCL reconstruction [12–14]. In addition, graft selection depends on the surgeon's experience, preference, tissue status, the age and activity level of the patient, concomitant diseases, the preoperative status, and the patient's wishes [12, 15, 16].…”

Section: Discussionmentioning

confidence: 99%

Comparing Dimensions of Four-Strand Hamstring Tendon Grafts with Native Anterior and Posterior Cruciate Ligaments

Yılmaz

Özdemir

Keskinöz

et al. 2016

BioMed Research International

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Background. The aim of the study was to evaluate whether or not there was any incompatibility between four-strand hamstring tendons taken from the same knee and the dimensions of the ACL and PCL. Methods. 15 fresh frozen cadaver hamstrings were prepared as four-strand grafts and measurements made of the ACL and PCL circumferences in the midsection were made in the narrowest part of the midsection. The cross-section areas and diameters were calculated with geometric calculations used to measure the cross-sectional area of cylinders. Accepting that the geometric insertions were elliptical, the length, width, and area were calculated for entry areas. Results. A significant relationship at 96.2% was determined between the ACL mid and the hamstring diameter. A significant relationship at 96.7% was determined between the ACL and the hamstring mid area. A significant relationship at 96.4% was determined between the PCL mid and the hamstring diameter. A significant relationship at 95.7% was determined between the PCL and the hamstring mid area. Conclusion. For the reconstruction of ACL and PCL, it was determined that there is less incompatibility between the four-strand hamstring tendons taken from the same knee and the dimensions of the midsection PCL compared to the ACL dimensions.

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Section: Discussionmentioning

confidence: 99%

Comparing Dimensions of Four-Strand Hamstring Tendon Grafts with Native Anterior and Posterior Cruciate Ligaments

Yılmaz

Özdemir

Keskinöz

et al. 2016

BioMed Research International

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“…15 The other RCT by Bottini et al showed that allograft reconstructions showed a 26.5% failure rate as compared to 8.3% failure in autograft reconstructions in the index operation. 14 These differences were found to be statistically significant (P=0.031). However when considering the Mariscalo et al the clinical failure risk showed no statistical difference in risk between autograft and allograft, (RR 0.75, 95% CI 0.25-2.24, P>0.05).…”

Section: Resultsmentioning

confidence: 85%

“…14 Patients were followed up until 10 years after initial procedure and outcomes were measured and compared. The primary outcomes measured were clearly stated as graft survivorship and subjective functional knee stability.…”

Section: Resultsmentioning

confidence: 99%

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Evaluating the functional results and complications of autograft vs allograft use for reconstruction of the anterior cruciate ligament: a systematic review

Pujji¹,

Keswani²,

Collier³

et al. 2017

Orthop Rev (Pavia)

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The aim of our review is to identify the reconstruction technique that has a superior functional outcome and decreased number of complications for the anterior cruciate ligament (ACL). We have divided our review into 2 sections. Our primary question evaluates the functional results and complications of autografts compared to allografts for ACL reconstruction. Our subsidiary question evaluates the functional results and complications of bone-patellar tendon-bone (BPTB) autografts compared to hamstring tendon autografts. We conducted a systematic review (SR) based on high quality evidence provided by Cochrane, PubMed and National Health Service evidence searches for papers comparing different ACL reconstruction techniques. Results from 2 primary studies, 1 SR and 1 meta-analysis showed no significant statistical difference when comparing clinical outcomes such as pain, range of motion, laxity, International Knee Documentation Committee score, single assessment numerical evaluation score, Tegner activity score and patient reported satisfaction with regards to autografts vs allografts. Allografts had worse outcomes for postoperative tibial tunnelling and graft failure. Results of 3 SRs showed statistically significant differences in incidence of anterior knee pain, kneeling pain and knee stability, which were all found to be greater amongst those who had received a BPTB autograft. Knee extension was significantly reduced in patients with BPTB grafts when compared to patients with Hamstring tendon autografts. However, with regards to return to prior levels of activity, there was no statistically significant difference between those that received BPTB autografts and those that received Hamstring tendon autografts. Autograft reconstruction of the ACL was shown to provide better postoperative outcomes when compared to allograft reconstruction, although the difference was not statistically significant. When researching different autograft options BPTB autografts were associated with greater pain but also greater stability of the knee joint postoperatively when compared to hamstring tendon autografts.

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“…Allograft tendons have been widely used for reconstructive surgery, especially in the knee joints, and no infections or immunological rejection have been reported [13–15]. Caprio and colleagues [2] described an augmented reconstructive technique of the ATFL and CFL with a semitendinosus tendon allograft, and they advocated this procedure as a safe, effective method to manage lateral ankle instability.…”

Section: Discussionmentioning

confidence: 99%

Allograft tendon reconstruction of the anterior talofibular ligament and calcaneofibular Ligament in the treatment of chronic ankle instability

Wang

2017

BMC Musculoskelet Disord

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BackgroundThe purpose was retrospectively to investigate functional and clinical outcomes after anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) reconstruction using a single allograft.MethodsPatients with severe chronic lateral instability of the ankle underwent surgery after conservative treatment failed. Ultrasounds of the ankle were performed, and if the AFTL and CFL were completely torn without enough soft tissue for repair, the ligaments were reconstructed using allograft tendon. Outcomes were assessed by clinical examination, stress radiography, ultrasound, the American Orthopaedic Foot and Ankle Society score (AOFAS), and Karlsson Ankle Functional score (KAFS) before surgery and at final follow-up.ResultsNineteen patients, ten men and nine women with mean age of 27.9 years (range, 19–41 years), underwent reconstruction. Mean follow-up was 30 months (range, 24–40 months). At final follow-up, all patients had returned to activity without instability, pain, or limited range of motion. On stress radiography, mean talar tilt angle decreased from 17.32° ± 3.58° before surgery to 4.16° ± 1.12° at follow-up (p < 0.001). Mean anterior drawer test (ADT) distance decreased from 9.79 ± 1.01 mm before surgery to 3.97 ± 0.99 mm at follow-up (p < 0.05). Mean AOFAS improved from 64.00 ± 18.43 to 90.32 ± 5.17 points (p < 0.001), and mean KAFS improved from 50.84 ± 16.73 to 90.89 ± 5.08 points (p < 0.001). Ultrasound showed the reconstructed ligaments maintained good continuity and excellent tension. No case of infection and immunological rejection was reported.ConclusionThis novel reconstruction technique takes into account the anatomical specialty of AFTL and CFL. This case series showed increased stability of the ankle in clinical and functional outcomes.Trial registrationThe trial registration number (TRN) and date of registration: ChiCTR-ORC-17010796, Mar 6th 2017. Retrospectively registered.

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Autograft Versus Allograft Anterior Cruciate Ligament Reconstruction

Abstract: At a minimum of 10 years after ACL reconstruction in a young athletic population, over 80% of all grafts were intact and had maintained stability. However, those patients who had an allograft failed at a rate over 3 times higher than those with an autograft.

Cited by 147 publications

References 64 publications

Comparing Dimensions of Four-Strand Hamstring Tendon Grafts with Native Anterior and Posterior Cruciate Ligaments

Comparing Dimensions of Four-Strand Hamstring Tendon Grafts with Native Anterior and Posterior Cruciate Ligaments

Evaluating the functional results and complications of autograft vs allograft use for reconstruction of the anterior cruciate ligament: a systematic review

Allograft tendon reconstruction of the anterior talofibular ligament and calcaneofibular Ligament in the treatment of chronic ankle instability

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