Knee Osteoarthritis After Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Versus Hamstring Tendon Autograft: A Systematic Review of Randomized Controlled Trials

Belk, John W.; Kraeutler, Matthew J.; Carver, Trevor J.; McCarty, Eric C.

doi:10.1016/j.arthro.2017.11.032

Cited by 24 publications

(23 citation statements)

References 28 publications

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“…The tendon–bone interface is unable to regenerate a direct-type insertion, and instead forms an indirect-type insertion with inferior biomechanical properties that can potentially lead to osteoarthritis [2–4, 20–22]. Based on our results, increased chondrocytes at the tendon–bone interface during the early phase after ACL reconstruction may be important for the formation of the fibrocartilage layers.…”

Section: Discussionmentioning

confidence: 79%

Development of fibrocartilage layers in the anterior cruciate ligament insertion in rabbits

Mutsuzaki

Nakajima

Someji

et al. 2019

BMC Musculoskelet Disord

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Background A detailed evaluation focusing on the fibrocartilage layers in the anterior cruciate ligament (ACL) insertion is necessary to consider regeneration of the insertion. This study examined the development of the fibrocartilage layers in the ACL tibial insertion in rabbits by quantitative morphometric evaluations based on histological and immunohistochemical analyses. Methods Male Japanese white rabbits were used because of their history of use for histomorphometric analyses of the ACL insertion and to eliminate the influence of female hormones on the ACL. Six animals were euthanized at each age (1 day and 1, 2, 4, 6, 8, 12, and 24 weeks); in total, 48 animals were used. Proliferation rate, apoptosis rate, Sox9-positive rate, and chondrocyte number were evaluated. Safranin O-stained glycosaminoglycan (GAG) areas, tidemark length, ACL insertion width, and ACL length were also evaluated. All parameters were compared with those at age 24 weeks of age. Results High levels of chondrocyte proliferation and Sox9 expression continued until 4 and 8 weeks of age, respectively, and then gradually decreased. Chondrocyte apoptosis increased up to 8 weeks. The chondrocyte number, ACL insertion width, ACL length, safranin O-stained GAG areas, and tidemark length gradually increased up to 12 weeks. Conclusion Chondrocytes that displayed chondrocyte proliferation and Sox9 expression increased until 12 weeks of age, in accordance with development of the ACL length and its insertion width. The GAG production and tidemark length also increased until 12 weeks of age. The development of fibrocartilage layers in the ACL insertion was complete at 12 weeks of age. Electronic supplementary material The online version of this article (10.1186/s12891-019-2614-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 79%

Development of fibrocartilage layers in the anterior cruciate ligament insertion in rabbits

Mutsuzaki

Nakajima

Someji

et al. 2019

BMC Musculoskelet Disord

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“…Zeng et al 12 also compared autograft with allograft ACLR across 9 RCTs and 10 systematic reviews and found that autografts had greater advantages than irradiated allografts with respect to function and stability, whereas there were no significant differences between autografts and nonirradiated allografts. In their review of 8 RCTs, Belk et al 14 found that BPTB or hamstring autograft had a similar incidence of postoperative knee OA at long-term followup. Similarly, Chee et al in their review of 19 RCTs comparing contemporary 4-strand hamstrings with patellar tendon autografts found comparable results in clinical stability and postoperative functional status across most parameters studied.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Numerous systematic reviews have been published looking at specific aspects of ACLR. [12][13][14] Notably, in their Level IV evidence systematic review of systematic reviews on ACLR, Anderson et al 15 provided a summary of 240 studies in an attempt to synthesize the literature, whereas Kay et al 16 focused on quality of reporting RCTs in ACLR and found that reporting of a methodologically sound randomization process and prospective calculation of sample size have significantly improved in recent years. The first of these 2 examples included all reviews of different study designs and the second focused on quality of reporting RCTs rather than the contents or results of those trials.…”

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confidence: 99%

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A Systematic Review of Randomized Controlled Trials in Anterior Cruciate Ligament Reconstruction: Standard Techniques Are Comparable (299 Trials With 25,816 Patients)

Matar

Platt

Bloch

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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To provide an overview of all published randomized controlled trials (RCTs) in anterior cruciate ligament reconstruction (ACLR) summarizing the available evidence. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched the Cochrane FIGCentral Register of Controlled Trials, Ovid MEDLINE, and Embase for RCTs of ACLR from their inception to August 26, 2020. Outcome measure was whether RCTs reported statistically significant findings. RCTs were then classified according to their intervention groups in a narrative synthesis of the evidence. Results: In total, 299 RCTs met the inclusion criteria and were included with a total number of 25,186 patients. Only 30 RCTs (10%) reported significant differences between the intervention and the control groups. These included 101 RCTs on grafts, 20 RCTs on tunnel placements, 48 RCTs on graft fixation, 42 RCTs on singlebundle compared with double-bundle reconstructions, 11 RCTs on additional procedures, 11 RCTs on graft tensioning, 5 RCTs on timing of surgery, 25 RCTs on technical variations from standard techniques, 6 RCTs on ACL repair, 5 RCTs on navigation, 16 RCTs on perioperative management, and 9 RCTs on other aspects of ACLR. Only 14 RCTs (4.7%) reported outcomes beyond 10 years with greater allograft failures compared with autografts, high incidence of osteoarthritic changes in reconstructed knees (22%-100%), with no significant differences in outcomes between bioabsorbable or metal screws for graft fixation, patellar versus hamstrings or single-versus double-bundle reconstructions. Conclusions: The evidence indicates that a standard arthroscopic single-or double-bundle ACLR with hamstrings/patella autografts, transportal technique, and fixation techniques familiar to the surgeon leads to comparable results. This evidence offers surgeons the flexibility to use standard and cost-effective techniques and achieve comparable outcomes. Level of Evidence: Level II; systematic review of Level I-II randomized controlled trials.

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“…benefit of ACL reconstruction (ACLR) in preventing PTOA in these patients. 11 In addition, recent systematic reviews of randomized controlled trials have demonstrated no difference in the risk of PTOA after ACLR with bone-patellar tendon-bone versus hamstring tendon autograft, 2 or after single-versus double-bundle ACLR. 3 Patients who sustain ACL rupture are more likely to undergo a total knee arthroplasty (TKA), 5 with 1.4% of patients with an ACL injury undergoing a TKA 15 years after ACLR compared with only 0.2% of case-matched controls.…”

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confidence: 99%

A Systematic Review of Basic Science and Animal Studies on the Use of Doxycycline to Reduce the Risk of Posttraumatic Osteoarthritis After Anterior Cruciate Ligament Rupture/Transection

et al. 2020

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Background: Posttraumatic osteoarthritis (PTOA) after injury to the anterior cruciate ligament (ACL) is common. Purpose: To perform a systematic review of basic science and animal studies to determine the effect of doxycycline treatment on the prevention of PTOA after ACL rupture/transection. Study Design: Systematic review. Methods: A systematic review was performed by searching the PubMed, Cochrane Library, and Embase databases to identify basic science and animal studies evaluating the effect of doxycycline treatment on the prevention of PTOA of the knee joint after ACL/cranial cruciate ligament (CCL) injury. The search phrase used was “doxycycline cruciate ligament.” Inclusion criteria were basic science and animal studies evaluating the effect of oral administration of doxycycline in ACL/CCL-deficient animals with or without a control group. Results: Seven studies met inclusion criteria and were included in this systematic review. Five studies were performed in dogs, 1 in rabbits, and 1 in mice. Overall, the effects of doxycycline treatment on the prevention of PTOA after ACL/CCL rupture/transection were mixed. In dogs, no significant effects of doxycycline treatment were found in terms of matrix metalloproteinase (MMP) activity, while a mouse study found significantly lower MMP-13 expression on the tibia in doxycycline-treated animals, suggesting that doxycycline may protect against proteoglycan loss and decrease osteoarthritis progression. Cartilage nitric oxide concentrations were lower in doxycycline-treated dogs compared with untreated dogs, suggesting decreased cartilage degradation among doxycycline-treated dogs, although there were no significant effects on cartilage stromelysin levels with no significant effects in terms of physiological remodeling or catabolism of cartilage. Bone formation or resorption was not found to be affected by doxycycline treatment. One study demonstrated a substantial beneficial effect of doxycycline on gross morphology of the medial femoral condyle. Doxycycline was found to conserve bone strain energy density and appeared to limit subchondral bone loss in 1 study. Conclusion: Based on the limited available animal studies, doxycycline appears to demonstrate some benefits in the prevention of PTOA after ACL/CCL rupture/transection. Additional studies are needed to further characterize the potential benefits, side effects, dosage, and duration of this treatment after ACL injury in human patients.

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Knee Osteoarthritis After Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Versus Hamstring Tendon Autograft: A Systematic Review of Randomized Controlled Trials

Cited by 24 publications

References 28 publications

Development of fibrocartilage layers in the anterior cruciate ligament insertion in rabbits

Development of fibrocartilage layers in the anterior cruciate ligament insertion in rabbits

A Systematic Review of Randomized Controlled Trials in Anterior Cruciate Ligament Reconstruction: Standard Techniques Are Comparable (299 Trials With 25,816 Patients)

A Systematic Review of Basic Science and Animal Studies on the Use of Doxycycline to Reduce the Risk of Posttraumatic Osteoarthritis After Anterior Cruciate Ligament Rupture/Transection

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