Comparison of hamstring tendon autograft and tibialis anterior allograft in arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction

Li, Bin; Wang, Jiashi; He, Mingguang; Wang, Guangbin; Shen, Ping; Bai, Lan

doi:10.1007/s00167-014-3267-z

Cited by 22 publications

(37 citation statements)

References 38 publications

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“…[10,11,13–15] There was significant heterogeneity ( I 2 = 75%, P = .003); therefore, a random model was performed. Pooling the results demonstrated that postoperative knee posterior stability in the autograft group was not significantly lower than that of the allograft group (MD = −0.45, 95% CI: −1.28 to 0.38, P = .29; Fig.…”

Section: Resultsmentioning

confidence: 99%

“…[13] Currently, the graft materials available for PCL reconstruction include autologous tendons, allograft tendons, and artificial ligaments, but the clinical use of artificial ligaments is uncommon. [7] Allograft tendons are widely used in clinical practice, [10,11,13–15] such as Achilles tendons, patellar tendons, hamstring tendons, and anterior tibial tendons. Operations using allograft tendons were shown to have shorter operative times and reduced soft tissue damage, as well as the ability to have grafts of adequate length and diameter.…”

Section: Discussionmentioning

confidence: 99%

“…The present meta-analysis included 5 studies in which there were no reports of disease transmission in patients receiving allograft tendon transplantation. [10,11,13–15] There were no differences in the functional scores between the gamma-irradiated allograft group and autograft group. [13,14] Thus, allogeneic tendon transplantation can be used to address the insufficiency of autogenous tendons due to multiple ligament injuries and cruciate ligament revision reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…[6–8] Autogeneic and allogeneic graft tissues have unique advantages and disadvantages. [9] Li et al [10] demonstrated that the outcomes were similar between hamstring tendon autografts and tibialis anterior allografts in single-bundle PCL reconstruction. Ahn et al [11] reported that the double-loop hamstring tendon autograft was as good as the Achilles tendon allograft for PCL reconstruction.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Tian

Hu²,

et al. 2017

Medicine

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Tian

Hu²,

et al. 2017

Medicine

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“…An incomplete view may require the use of the posteromedial portal for adequate visualization. 5 Although an anatomic position of the tibial footprint is possible using transtibial drilling, graft passage with this technique is difficult because of a sharp turn when placing the graft into the tibial tunnel. It has been shown that the sharp turn during the transtibial technique may damage graft fibers.…”

Section: Discussionmentioning

confidence: 99%

Inside-Out Antegrade Tibial Tunnel Drilling Through the Posterolateral Portal Using a Flexible Reamer in Posterior Cruciate Ligament Reconstruction

Alentorn-Geli

Stuart

Choi

et al. 2015

Arthroscopy Techniques

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Posterior cruciate ligament (PCL) reconstruction using the transtibial drilling or arthroscopic tibial-inlay technique has a risk of injury to the popliteal neurovascular bundle because a pin is drilled anterior to posterior. Intraoperative fluoroscopy is used to decrease the risk of neurovascular injury. In addition, graft passage in the transtibial technique may be problematic because of a sharp turn when placing the graft into the tibial tunnel, which may damage graft fibers. In the surgical technique described in this report, the posteromedial portal is used for visualization and the posterolateral portal is used for debridement of the PCL tibial footprint and the synovial fold closest to the PCL. A curved guide is placed from the posterolateral portal to the tibial footprint, and a flexible pin is drilled across the tibia. The tibial tunnel is then created using a flexible reamer under direct visualization up to the desired length, and a graft can be positioned in the tibial tunnel through the posterolateral portal. This technique has the potential advantages of decreasing the risk of injury to the popliteal neurovascular bundle (use of anteriorly directed, inside-out drilling), avoiding a sharp turn during graft passage, and allowing accurate and anatomic tibial tunnel placement without intraoperative fluoroscopy.

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How to avoid collision between PCL and MCL femoral tunnels during a simultaneous reconstruction

Grassedonio

Lauria

Midiri

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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The results of this study can help surgeons to better direct the femoral MCL tunnel in order to avoid a collision between femoral tunnels during a combined MCL and PCL reconstruction. In order to minimize such potential complications, the MCL tunnel should be created limiting the axial angulation and it should be drilled with a proximal angulation from 20° to 40°, depending on the medial condyle width.

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Comparison of hamstring tendon autograft and tibialis anterior allograft in arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction

Abstract: Retrospective comparative study, Level III.

Cited by 22 publications

References 38 publications

Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Inside-Out Antegrade Tibial Tunnel Drilling Through the Posterolateral Portal Using a Flexible Reamer in Posterior Cruciate Ligament Reconstruction

How to avoid collision between PCL and MCL femoral tunnels during a simultaneous reconstruction

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