Musculoskeletal Allograft Risks and Recalls in the United States

Mroz, Thomas E.; Joyce, Michael; Steinmetz, Michael P.; Lieberman, Isador H.; Wang, Jeffrey C.

doi:10.5435/00124635-200810000-00001

Cited by 125 publications

(88 citation statements)

References 14 publications

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“…Their main drawbacks include risk of disease transmission, cost, risk of inferior mechanical properties due to processing techniques, and potentially longer incorporation times. 32,34,35 40 Although, these claims have not been substantiated in the literature, anecdotally we can confirm that we have not observed any adverse events related to allograft tissue treated with this formula at our institution. The use of an acellular dermal matrix (GraftJacket, Wright Medical Technology, Arlington, TN) to augment the repair of tears affecting greater than 50% of the peroneal tendons has also recently been reported.…”

Section: Dojsupporting

confidence: 53%

Allograft Reconstruction of Irreparable Peroneal Tendon Tears: A Preliminary Report

Nunley¹,

Riboh²,

Godin³

et al. 2013

The Duke Orthopaedic Journal

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Background: Peroneal tendon injuries represent a significant but underappreciated source of lateral ankle pain. Partial thickness tears of the peroneus brevis amenable to direct repair techniques are common. Irreparable tears are uncommon and require more complex surgical decision-making. Intercalary segment allograft reconstruction has been previously described as a treatment option; however, there are no reports of the outcomes of this technique in the literature. We present our results utilizing this technique.

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Section: Dojsupporting

confidence: 53%

Allograft Reconstruction of Irreparable Peroneal Tendon Tears: A Preliminary Report

Nunley¹,

Riboh²,

Godin³

et al. 2013

The Duke Orthopaedic Journal

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“…Allografts have the main advantages of eliminating donor-site morbidity, availability of multiple grafts, shorter operative times, less postoperative pain and faster rehabilitation [4,5]. However, allografts have the major disadvantages of the risk for disease transmission, possible immunogenicity, and slower incorporation or ligamentization [6,7]. To reduce the potential of disease transmission, gamma irradiation used to be a popular option for allografts secondary sterilization.…”

Section: Introductionmentioning

confidence: 99%

Allograft versus autograft for anterior cruciate ligament reconstruction: an up-to-date meta-analysis of prospective studies

et al. 2012

International Orthopaedics (SICOT)

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Purpose Although a large number of anterior cruciate ligament (ACL) reconstructions are performed annually, there remains a considerable amount of controversy over whether an autograft or an allograft should be used. The aim of this meta-analysis was to compare the clinical outcomes of allograft and autograft in primary ACL reconstruction. Methods The authors systematically searched electronic databases to identify prospective studies which compared allografts with autografts for primary ACL reconstruction. The results of the eligible studies were analysed in terms of instrumented laxity measurements, Lachman test, Pivot Shift test, objective International Knee Documentation Committee (IKDC) Scores, Lysholm Scores, Tegner Scores, and clinical failures. Study quality was assessed and relevant data were extracted independently by two reviewers. A random effect model was used to pool the data. Statistical heterogeneity between trials was evaluated by the chi-square and I-square tests. Results Nine studies, with 410 patients in the autograft and 408 patients in the allograft group, met the inclusion criteria. Five studies compared bone-patellar tendon-bone (BPTB) grafts, and four compared soft-tissue grafts. Four studies were randomized controlled trials, and five were prospective cohort studies. The results of the meta-analysis showed that there were no significant differences between allograft and autograft on all the outcomes in terms of instrumented laxity measurements (P 00.59), Lachman test (P 00.41), Pivot

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“…Moreover, this technique spares the need for using allografts, which are associated with increased financial costs 8 ; concerns of low tissue quality, particularly with irradiated grafts; slower biological incorporation 9 and graft remodeling 13 ; disease transmission 10 ; and some evidence of higher failure rates and inferior functional outcomes in young active adults, at least for the ACL. 11 Furthermore, using quadriceps tendonebone autograft for reconstructing the MCL can also be applied to other scenarios as well, such as in rare cases of chronic isolated MCL instability or by surgeons who prefer to reconstruct the ACL with autologous hamstring tendons and wish to use autograft also for their MCL reconstruction in the combined MCL-ACLedeficient knee.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] When autograft was used for MCL reconstruction, the semitendinosus was the exclusive autologous graft choice described. [5][6][7] The disadvantages of using allografts for reconstructing the knee ligaments relate to financial costs, 8 concerns regarding tissue quality with slower biological incorporation, 9 disease transmission, 10 and some evidence of higher failure rates and inferior functional outcomes in young active adults, at least for the ACL. 11 The potential disadvantages of using autologous hamstring for reconstructing the MCL in the ACL-deficient knee include weakening of the hamstring's anterior restraining action.…”

mentioning

confidence: 99%

Combined Reconstruction of the Medial Collateral Ligament and Anterior Cruciate Ligament Using Ipsilateral Quadriceps Tendon–Bone and Bone–Patellar Tendon–Bone Autografts

Hetsroni¹,

Mann²

2016

Arthroscopy Techniques

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Abstract:The exclusive autograft choice for medial collateral ligament (MCL) reconstruction that has been described until today is the semitendinosus tendon. However, this has some potential disadvantages in a knee with combined MCLeanterior cruciate ligament (ACL) injury, including weakening of the hamstring's anterior restraining action in an already ACL-injured knee and nonanatomic distal MCL graft insertion when leaving the semitendinosus insertion intact at the pes anserinus during reconstruction. Moreover, because some surgeons prefer to use the hamstring for autologous ACL reconstruction, the contralateral uninjured knee hamstring needs to be harvested as a graft source for the MCL reconstruction if autografts and not allografts are the surgeons' preference. We describe a technique for performing combined reconstruction of the MCL and ACL using ipsilateral quadriceps tendonebone and boneepatellar tendonebone autografts. This technique of MCL reconstruction spares the hamstring tendons and benefits from the advantage provided by bone-to-bone healing on the femur with distal and proximal MCL tibial fixation that closely reproduces the native MCL tibia insertion.

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Musculoskeletal Allograft Risks and Recalls in the United States

Cited by 125 publications

References 14 publications

Allograft Reconstruction of Irreparable Peroneal Tendon Tears: A Preliminary Report

Allograft Reconstruction of Irreparable Peroneal Tendon Tears: A Preliminary Report

Allograft versus autograft for anterior cruciate ligament reconstruction: an up-to-date meta-analysis of prospective studies

Combined Reconstruction of the Medial Collateral Ligament and Anterior Cruciate Ligament Using Ipsilateral Quadriceps Tendon–Bone and Bone–Patellar Tendon–Bone Autografts

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