Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Abstract

Background:The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to compare the clinical outcomes of autograft versus allograft tendons in patients who underwent posterior cruciate ligament (PCL) reconstruction.Methods:We conducted a search of PubMed, EMBASE, The Cochrane Library, and Web of Science databases for RCTs and non-RCTs comparing autograft and allograft tendons in PCL reconstruction up to August 2016. The outcomes were Lysholm knee function score, postoperative objective and subjective International Knee Documentation Committee Score (IKDCS), Tegner activity scale, and knee posterior stability. Data analysis was performed using RevMan 5.3 software.Results:One RCT and 4 non-RCTs met the inclusion criteria. The current meta-analysis indicated that there were no significant differences in the Lysholm knee function score (mean difference [MD] = −0.99, 95% confidence interval [CI]: −5.51 to 3.54, P = .67), Tegner activity scale (MD = 0.46, 95% CI: 0.03 to 0.90, P = .04), postoperative objective IKDCS (odds ratio [OR] = 1.66, 95% CI: 0.77 to 3.58, P = .20), postoperative subjective IKDCS (MD = 3.00, 95% CI: −0.29 to 6.29, P = .07), or knee posterior stability (MD = −0.45, 95% CI: −1.28 to 0.38, P = .29) between patients who received autograft tendons and those who received allograft tendons. The patients with autograft tendons had a higher Tegner activity scale (MD = 0.46, 95% CI: 0.03 to 0.90, P = .04) than those with allograft tendons.Conclusions:The present meta-analysis shows that there was insufficient evidence to indicate that allograft tendons were significantly better than autograft tendons for PCL reconstruction. Due to the limited quality and data in the studies currently available, in the future, more high-quality RCTs are required to answer this question more definitively.

Allografts in reconstruction of the posterior cruciate ligament: a health economics perspective

“…Tian et al [ 22 ] provide a meta-analysis of autograft and allografts in PCL reconstruction but include only five studies, the RCT by Li et al [ 12 ], and CCTs by Ahn et al [ 1 ], Li et al [ 11 ], Sun et al [ 21 ] and Wang et al [ 23 ], some of which we would exclude. Ahn et al [ 1 ] had only 18 patients in each group.…”

Posterior cruciate ligament reconstruction implemented by the Ligament Advanced Reinforcement System over a minimum follow-up of 10 years

“…The aforementioned study published by Wang et al [14] in 2017 indicated that the average Lysholm score and Tegner activity score in an autogenous semitendinosus group were 86.2 and 7.68, respectively, whereas those in a hypothermia allogeneic tendon group were 85.0 and 7.74, respectively. A meta-analysis conducted by Tian et al [18] in 2017 demonstrated that the average Lysholm score and Tegner activity score in an autograft group were 82-87.8 and 4.7-7.7, respectively, whereas those in an allograft group were 84-92.3 and 4.7-7.1, respectively. A systematic review conducted by Lee et al [19] in 2018 revealed no statistically significant differences in the clinical results regardless of graft sources.…”

Comparative Effectiveness and Safety of Allografts and Autografts in Posterior Cruciate Ligament Reconstruction Surgery: A Systematic Review

“…34 Some reviews reported no significant differences in postoperative functional outcomes using autografts compared to allografts, 14,15 whereas another metaanalysis reported insufficient evidence to report the superiority of allografts over autografts due to poor quality and data availability. 27,28 This review distinguishes the safety outcomes of PCL reconstruction from the effectiveness outcomes and suggests that there is insufficient evidence to judge superiority or inferiority of a particular graft type. It emphasizes poorly measured and reported complications because none of the primary studies reported on graft failure rates or revision or rerupture rates despite the reported graft failure rates of 11.6% and 12.6% mentioned in other studies.…”