Improved ACL reconstruction outcome using double-layer BPTB allograft compared to that using four-strand hamstring tendon allograft

Niu, Yingzhen; Niu, Chao; Liu, Junhang; Cao, Pengkai; Wang, Fei; Niu, Jinghui

doi:10.1016/j.knee.2016.06.015

Cited by 12 publications

(13 citation statements)

References 29 publications

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“…The full texts of 216 studies were assessed for eligibility, of which 32 were excluded for <1 year follow-up, 32 for comparing different fixations using the same graft, 34 for quasi-randomized controlled trials, and 73 for no related data provided. Finally, 45 studies 7 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 were included for our analysis. Fig 1 shows the selection process for relevant studies.…”

Section: Resultsmentioning

confidence: 99%

“…In the included studies, the mean age of patients ranged from 20.1 to 42 years, and the percentage of female patients ranged from 13% to 100%. In terms of the grafts used, 17 studies 29 , 30 , 32 , 33 , 36 , 39 , 43 , 47 , 51 , 54 , 55 , 58 , 66 , 69 , 70 , 71 , 72 compared patellar tendon autograft (PT-AU) with hamstring tendon autograft (HT-AU), 5 studies 31 , 37 , 38 , 48 , 52 compared PT-AU with semitendinosus tendon autograft (ST-AU), 4 studies 63 , 64 , 67 , 68 compared HT-AU with hamstring tendon allograft (HT-AL), 3 studies 7 , 40 , 42 compared PT-AU with Art-L, 2 studies 41 , 46 compared HT-AU with ST-AU, 2 studies 49 , 65 compared HT-AU with tibialis anterior tendon allograft (TA-AL), 2 studies 61 , 62 compared PT-AU with patellar tendon allograft (PT-AL), 2 studies 35 , 56 compared PT-AL with HT-AL, and 1 study 50 performed a comparison among PT-AU, HT-AU, and ST-AU. In addition, 1 study compared HT-AU with tibialis posterior allograft (TP-AL), 34 1 compared HT-AU with PT-AL, 44 1 compared PT-AL with tibialis anterior allograft (TA-AL), 45 1 compared PT-AU with QT-AU, 53 1 compared HT-AU with Achilles tendon allograft (Ac-AL), 57 1 compared HT-AU with peroneus longus tendon autograft (PLT-AU), 59 and 1 compared PT-AU with ilitibial band autograft (ITB-AU).…”

Section: Resultsmentioning

confidence: 99%

“…In terms of Lysholm score, 16 studies 32 , 35 , 36 , 43 , 45 , 46 , 47 , 56 , 60 , 61 , 62 , 63 , 64 , 65 , 67 , 68 were analyzed ( Appendix ). Similar to the results of IKDC, no significant difference was found in this outcome among the comparisons.…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-seven studies mentioned complications, of which 4 studies 35 , 45 , 71 , 72 reported no complications and 33 studies 7 , 29 , 30 , 31 , 34 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 47 , 48 , 49 , 50 , 52 , 53 , 54 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 70 mentioned various complications. All the complications are listed in the Appendix .…”

Section: Resultsmentioning

confidence: 99%

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Comparative Efficacy of Graft Options in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Network Meta-Analysis

Liu

Yang

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To evaluate the effectiveness of various graft options for anterior cruciate ligament reconstruction using network meta-analysis. Methods A medical literature search was conducted of PubMed, the Cochrane Library, Embase, SCOPUS, and Web of Science from their inception through March 1, 2019. The outcomes, including International Knee Documentation Committee (IKDC) form, Lachman test, Lysholm score, Pivot shift test, and Tegner score, were evaluated among graft options. Data extraction was carried out according to inclusion and exclusion criteria, and a network meta-analysis was performed using STATA 14.0. Results A total of 45 trials with 3992 patients were included. The forest plots revealed no significant differences in IKDC, Lysholm, or Tegner score among the grafts. In Lachman score, a significant difference was found in the comparisons of hamstring tendon allograft (HT-AL) versus patellar tendon autograft (PT-AU) and HT-AL versus hamstring tendon autograft (HT-AU). In pivot shift test, PT-AU was superior to all the other grafts, and quadriceps tendon autograft (QT-AU) was superior to HT-AL and artificial ligament (Art-L) in the number of cases with negative results. According to surface under the cumulative ranking area (SUCRA), PT-AU had the highest probability to be the best intervention in Lachman test and Tegner score; tibialis anterior tendon allograft (TA-AL) in IKDC and Lysholm score; and QT-AU in pivot shift test. Based on the cluster analysis of SUCRA, PT-AU was considered the most appropriate intervention by IKDC and Lachman test. Conclusion This study suggests that PT-AU may be the most appropriate graft for ACL reconstruction according to IKDC and Lachman test results. Level of Evidence Level I, network meta-analysis of randomized controlled trials.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Comparative Efficacy of Graft Options in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Network Meta-Analysis

Liu

Yang

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…There are various options when choosing an allograft for the ACL reconstruction. Besides the origin of the graft, preservation and sterilization methods are variable 10 . Each type of graft can be fresh-frozen, cryopreserved or freeze-dried.…”

Section: Discussionmentioning

confidence: 99%

Comparison of freeze-dried tibialis anterior allograft and four-strand hamstring autograft in anterior cruciate ligament reconstruction

Issın

Öner²,

Sofu

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

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The use of allograft tendons in primary ACL reconstruction

Hulet

Sonnery‐Cottet

Stevenson

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose Graft choice in primary anterior cruciate ligament (ACL) reconstruction remains controversial. The use of allograft has risen exponentially in recent years with the attraction of absent donor site morbidity, reduced surgical time and reliable graft size. However, the published evidence examining their clinical effectiveness over autograft tendons has been unclear. The aim of this paper is to provide a current review of the clinical evidence available to help guide surgeons through the decision-making process for the use of allografts in primary ACL reconstruction. Methods The literature in relation to allograft healing, storage, sterilisation, differences in surgical technique and rehabilitation have been reviewed in addition to recent comparative studies and all clinical systematic reviews and meta-analyses. Results Early reviews have indicated a higher risk of failure with allografts due to association with irradiation for sterilisation and where rehabilitation programs and post-operative loading may ignore the slower incorporation of allografts. More recent analysis indicates a similar low failure rate for allograft and autograft methods of reconstruction when using non-irradiated allografts that have not undergone chemically processing and where rehabilitation has been slower. However, inferior outcomes with allografts have been reported in young (< 25 years) highly active patients, and also when irradiated or chemically processed grafts are used. Conclusion When considering use of allografts in primary ACL reconstruction, use of irradiation, chemical processing and rehabilitation programs suited to autograft are important negative factors. Allografts, when used for primary ACL reconstruction, should be fresh frozen and non-irradiated. Quantification of the risk of use of allograft in the young requires further evaluation. Levels of evidence III. Keywords Anterior cruciate ligament reconstruction • Allografts • ACL • Graft choice • Decision making • AutograftsThis work performed as part of the ESSKA Arthroscopy Committee.

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Improved ACL reconstruction outcome using double-layer BPTB allograft compared to that using four-strand hamstring tendon allograft

Cited by 12 publications

References 29 publications

Comparative Efficacy of Graft Options in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Network Meta-Analysis

Comparative Efficacy of Graft Options in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Network Meta-Analysis

Comparison of freeze-dried tibialis anterior allograft and four-strand hamstring autograft in anterior cruciate ligament reconstruction

The use of allograft tendons in primary ACL reconstruction

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