Autograft versus allograft in anterior cruciate ligament reconstruction

Kan, Shun-Li; Yuan, Zhi-Xin; Pan, Dayu; Yang, Bo; Li, Hailiang; Sun, Jun; Feng, Shiqing

doi:10.1097/md.0000000000004936

Cited by 30 publications

(24 citation statements)

References 47 publications

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“…When ACL surgery is required, the reconstruction can be performed by using either autograft or allograft tissue. It has been shown that autograft is superior to irradiated allograft with regards to knee functional outcomes and laxity 11 . The standard surgical autogenous harvest sites are patellar and hamstrings tendons and it has been recently pointed out that the short and long-term outcomes of these grafts are similar in providing stability and function [12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Timing of Muscle Activation Is Altered During Single-Leg Landing Tasks After Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport

Rocchi

Labanca

Laudani

et al. 2020

Clinical Journal of Sport Medicine

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Patients and intervention: Fifteen male athletes following ACL-R using patellar tendon and 11 using hamstrings autograft at the time of return to sport were recruited. Fifteen healthy athletes served as control group. Participants performed 4 different single-leg landing tasks arriving onto a force plate. Main outcome measures: Electromyographic (EMG) activity of knee extensors and flexors, normalized vertical ground reaction force and knee angular displacement were recorded. Results: In all the tasks pre-impact EMG duration was longer in ACL-R (112±28 ms in the knee extensors; 200±34 ms in the knee flexors) compared to healthy participants (74±19 ms in the knee extensors; 153±29 ms in the knee flexors; P<0.05). Initial Contact and Maximum Post-Impact knee angle were lower in ACL-R (9±7 degrees at Initial Contact; 39±12 degrees at maximum flexion) compared to healthy participants (17±9 degrees at Initial Contact; 52±15 degrees at maximum flexion; P<0.05). Normalized vertical GRF was higher in ACL-R compared to healthy participants (3.4±0.5 and 2.7±0.6; P<0.05). Conclusion: At the time of return to sport ACL-R subjects showed altered motor control strategies of single-leg landings. These alterations may lead to uncoordinated movement, hence increasing the risk of re-injury.

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Section: Introductionmentioning

confidence: 99%

Timing of Muscle Activation Is Altered During Single-Leg Landing Tasks After Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport

Rocchi

Labanca

Laudani

et al. 2020

Clinical Journal of Sport Medicine

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“…The ACL accounts for approximately 50% knee injuries caused by sports activities due to movements that cause extreme strain and rotation of the knee, direction change, immediate halting or outer impacts [ 5 ]. ACL reconstruction, as a kind of common orthopaedic procedure in surgery worldwide, is regarded as the standard surgical procedure for the treatment of ACL tear [ 6 ]. Occasionally combined with extra-articular plastic/augmentation, ACL reconstruction is carried out arthroscopically using autograft or allograft [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

A comparative study of effect of autograft compared with allograft anterior cruciate ligament reconstruction on expressions of LOXs and MMPs

Wang

Huang

et al. 2017

Bioscience Reports

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The present study aimed to compare the effect of autograft or allograft anterior cruciate ligament (ACL) reconstruction on the expressions of lipoxygenases (LOXs) and matrix metalloproteinases (MMPs) in a New Zealand white rabbit model. New Zealand white rabbits were divided randomly into control, sham, autograft and allograft groups. At the 4th and 8th week after operation, biomechanical testing was performed to measure the primary length, cross-sectional area, maximum tensile load and stiffness of ACL, and HE staining was used to observe cell morphology and fibre alignment of ACL. At the 2nd, 4th and 8th week after operation, quantitative real-time PCR (qRT-PCR), Western blotting and immunohistochemistry were applied to detect LOXs and MMPs expressions, and expressions of adenomatous polyposis coli (APC)/Wnt signalling pathway-related proteins. At the 4th and 8th week after operation, the maximum tensile load and stiffness were higher in the autograft group than in the allograft group, and the values at the 8th week were higher than those at the 4th week after operation. The fibroblast proliferation in the allograft group was more significant than that in the autograft group. Compared with the control group, LOXs and MMPs expressions and the positive expression rates of LOXs and MMPs proteins were elevated, and the values in the allograft group were higher than those in the autograft group at all time points. At 8th week after operation, compared with the autograft group, Wnt expression was higher and APC expression was lower in the allograft group. Autograft and allograft ACL reconstruction can promote LOXs and MMPs expressions by activating the APC/Wnt signalling pathway.

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“…One further meta-analysis 37 found comparative evidence consisting of 13 RCTs (n ¼ 1636). While the e16 review was less strict and also included studies with a shorter follow-up, the review concluded that autografts are superior when compared with irradiated allografts in ACLR based on knee function as well as laxity.…”

Section: Discussionmentioning

confidence: 99%

Allograft for Anterior Cruciate Ligament Reconstruction (ACLR): A Systematic Review and Meta-Analysis of Long-Term Comparative Effectiveness and Safety. Results of a Health Technology Assessment

Goetz

Villiers

Sadoghi

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To evaluate whether allograft anterior cruciate ligament reconstruction (ACLR) is superior or inferior to autograft ACLR or conservative management in terms of effectiveness and safety. Methods: A systematic review of the evidence for allograft ACLR was conducted. Randomized controlled trials with a minimum mean follow-up time of 5 years were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the EUnetHTA-Core-Model were used as reporting standards. A meta-analysis was conducted for selected crucial outcomes using a random-effects model. The strength of the available evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Six randomized trials were included comparing allograft with autograft. Patients were on average between 28 and 32.8 years of age (allograft group) and 28.9 and 31.7 years of age (autograft group). Based on the crucial outcomes, the meta-analyses showed no statistically significant differences in Lysholm score, Tegner score, and Cincinnati Knee Score between groups. A small statistical difference favoring autografts was found across studies in the subjective International Knee Documentation Committee score (e2.25; 95% confidence interval e3.02 to e1.47; I 2 ¼ 0%; range of all scores: 73.7-90). Two of six studies reported on graft failure, with a statistically significant difference to the detriment of using allografts (13/49 [26.5%] vs 4/48 [8.3%] in one study, 13/43 [30.2%] vs 3/40 [7.5%] in the other study). Conclusions: Although no substantial difference in patient-reported function, activity level, and symptoms was demonstrated, evidence from the included studies showed a greater risk for graft failure or revision that may make allograft a less safe treatment modality in ACLR. The strength of available evidence is low based on the crucial outcomes due to the lack of high-quality research and the present increased risk of bias in primary studies. Priority should be shifted toward reflecting on whether there is a subpopulation for whom allograft ACLR may still be advantageous in theory (e.g., less-active older patients) and further conduct RCTs in this population. Level of Evidence: Level II, systematic review of Level II evidence studies.

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Autograft versus allograft in anterior cruciate ligament reconstruction

Abstract: Supplemental Digital Content is available in the text

Cited by 30 publications

References 47 publications

Timing of Muscle Activation Is Altered During Single-Leg Landing Tasks After Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport

Timing of Muscle Activation Is Altered During Single-Leg Landing Tasks After Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport

A comparative study of effect of autograft compared with allograft anterior cruciate ligament reconstruction on expressions of LOXs and MMPs

Allograft for Anterior Cruciate Ligament Reconstruction (ACLR): A Systematic Review and Meta-Analysis of Long-Term Comparative Effectiveness and Safety. Results of a Health Technology Assessment

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