Clinical Outcomes of the Central Third Patellar Tendon Versus Four-strand Hamstring Tendon Autograft Used for Anterior Cruciate Ligament Reconstruction: A Systematic Review and Subgroup Meta-analysis of Randomized Controlled Trials

He, Xin; Yang, Xiong‐gang; Feng, Jiangtao; Wang, Rui; Huang, Hongchao; He, Jinquan; Hu, Yongcheng

doi:10.1016/j.injury.2020.05.025

Cited by 11 publications

(38 citation statements)

References 57 publications

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“…A meta-analysis of 23 RCTs compared the outcomes of 1986 patients undergoing primary ACLR with HT autograft ( n = 993) or BPTB autograft ( n = 993). 13 The patients had a mean age between 21.7 years and 38.0 years and were followed-up between 12 months to 17 years. There was a significant improvement in function within the HT autograft group at a medium-term follow-up (3–5 years) compared to BPTB autograft, objective IKDC score (P = 0.017).…”

Section: Hamstrings Tendon Autograftsmentioning

confidence: 99%

Current concepts in graft selection for anterior cruciate ligament reconstruction

et al. 2021

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Graft selection for anterior cruciate ligament reconstruction (ACLR) is important for optimizing post-operative rehabilitation, facilitating return to full sporting function and reducing the risk of complications. The most commonly used grafts for ACLR include hamstring tendon autografts, bone–patellar tendon–bone autografts, quadriceps tendon autografts, allografts and synthetic grafts. This instructional review explores the existing literature on clinical outcomes with these different graft types for ACLR and provides an evidence-based approach for graft selection in ACLR. The existing evidence on the use of extra-articular tenodesis to provide additional rotational stability during ACLR is also revisited. Cite this article: EFORT Open Rev 2021;6:808-815. DOI: 10.1302/2058-5241.6.210023

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Section: Hamstrings Tendon Autograftsmentioning

confidence: 99%

Current concepts in graft selection for anterior cruciate ligament reconstruction

et al. 2021

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“…Sixteen of the studies reported the sample size of patients undergoing ACL rupture (ACLR) with a BPTB autograft, as well as the sample size of patients with an HT autograft [5][6][7][8][10][11]13,18,[21][22][25][26][27][28][29][30]. The remaining five reported a total number of patients [15][16]20,[23][24], one reported the total sample and specified the graft the majority received, but a small number remained unknown [19].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Another one reported a number of series [9] and three did not specify the sample size [12,14,17]. Twenty-one of the studies reported on short-term outcomes [5][6][7][8][9][10][11][12][13][15][16][17][18][19][21][22][23][24][25]27,30], four on long-term outcomes [14,20,[28][29], and another reported one on all three, short-, mid-, and long-term outcomes [26].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…. Tegner knee score: Seven meta-analyses reported on the Tegner knee score outcome and none concluded in a statistically significant difference between the two grafts[8,15,23,[26][27][28][29].Freedman et al could not combine data due to significant heterogeneity[6] and Goldblatt et al demonstrated only a graphical analysis with no apparent differences[8] 5…”

mentioning

confidence: 99%

“…. Side-to-side differences (SSD): Eighteen meta-analyses presented data on side-to-side differences by instrumented laxity[5][6][7][8][9][10][14][15][16][20][21][23][24][25][26][27][28][29], and 10 of them found no statistically significant difference. Yunes et al and Xie et al found a trend toward favoring the BPTB graft though this did not reach significance[5,21].…”

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confidence: 99%

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A Systematic Approach for Stronger Documentation of Anterior Cruciate Ligament Graft Choice

Arida¹,

Mastrokalos²,

Panagopoulos³

et al. 2021

Cureus

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Numerous studies have focused on determining the optimal choice between the two most used anterior cruciate ligament (ACL) reconstruction autografts. In order to address this matter, we performed a systematic review of every meta-analysis published on the PubMed platform between 2001 and 2020, comparing the functional outcomes, the static stability parameters, as well as the postoperative and longterm complications of the patellar tendon (BPTB) autograft and hamstrings (HT). We retrieved a total of 26 meta-analyses that met our criteria, and the characteristics and outcomes of every meta-analysis, as well as subgroup analysis regarding the type of the study design, number of strands of HT autograft, and fixation method, were extensively recorded. The majority of the meta-analyses showed that there were no significant differences between BPTB and HT in terms of functional outcomes and static stability parameters while HT autografts seem to be superior to BPTB regarding kneeling pain and anterior knee pain. Other outcomes seem to be affected by the number of strands of the HT autograft, the fixation technique, and the type of study design, indicating superiority of the four-strand HT autograft with the use of an extra-cortical button fixation. Overall, there is no clear superiority of BPTB over HT autografts for ACL reconstruction, as both types present similar outcomes in the majority of postoperative parameters. Autograft selection should be individualized according to each patient's needs and more RCTs are warranted in order to reach safer results on the appropriate autograft type.

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Evaluating the quality of systematic reviews of comparative studies in autograft‐based anterior cruciate ligament reconstruction using the AMSTAR‐2 tool: A systematic umbrella review

Sritharan,

Milantoni,

Abdel Khalik

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThere remains a lack of consensus around autograft selection in anterior cruciate ligament reconstruction (ACLR), though there is a large body of overlapping systematic reviews and meta‐analyses. Systematic reviews and their methodological quality were aimed to be further assessed, using a validated tool known as assessing the methodological quality of systematic reviews (AMSTAR‐2).MethodsMEDLINE, Embase and CENTRAL were searched from inception to 23 April 2023 for systematic reviews (with/without meta‐analysis) comparing primary ACLR autografts. A final quality rating from AMSTAR‐2 was provided for each study (‘critically low’, ‘low’, ‘moderate’ or ‘high’ quality). Correlational analyses were conducted for ratings in relation to study characteristics.ResultsTwo thousand five hundred and ninety‐eight studies were screened, and 50 studies were ultimately included. Twenty‐four studies (48%) were rated as ‘critically low’, 17 (34%) as ‘low’, seven (14%) as ‘moderate’ and two (4%) as ‘high’ quality. The least followed domains were reporting on sources of funding (1/50 studies), the impact of risk of bias on results of meta‐analyses (11/36 studies) and publication bias (17/36 studies). There was a significant increase in the frequency of studies graded as ‘moderate’ compared to ‘low’ or ‘critically low’ quality over time (p = 0.020).ConclusionThe methodological quality of systematic reviews comparing autografts in ACLR is low, with many studies being rated lower due to commonly absent aspects of systematic review methodology such as investigating sources of funding and publication bias. More recent studies were generally more likely to be of higher quality. Authors are advised to consult AMSTAR‐2 prior to conducting systematic reviews in ACLR.Level of Evidence: Level IV.

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Clinical Outcomes of the Central Third Patellar Tendon Versus Four-strand Hamstring Tendon Autograft Used for Anterior Cruciate Ligament Reconstruction: A Systematic Review and Subgroup Meta-analysis of Randomized Controlled Trials

Cited by 11 publications

References 57 publications

Current concepts in graft selection for anterior cruciate ligament reconstruction

Current concepts in graft selection for anterior cruciate ligament reconstruction

A Systematic Approach for Stronger Documentation of Anterior Cruciate Ligament Graft Choice

Evaluating the quality of systematic reviews of comparative studies in autograft‐based anterior cruciate ligament reconstruction using the AMSTAR‐2 tool: A systematic umbrella review

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