Prospective Randomized Comparison of Knee Stability and Proprioception for Posterior Cruciate Ligament Reconstruction With Autograft, Hybrid Graft, and γ-Irradiated Allograft

Li, Jia; Kong, Fanlong; Gao, Xianda; Shen, Yong; Gao, Shijun

doi:10.1016/j.arthro.2016.04.024

Cited by 27 publications

(49 citation statements)

References 23 publications

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“…[13–15] Significant heterogeneity was found, and a random model was used ( I 2 = 81%, P = .005). The Lysholm knee function score in the autograft group was not significantly higher than that of the allograft group (MD = −0.99, 95% CI: −5.51 to 3.54, P = .67; Fig.…”

Section: Resultsmentioning

confidence: 99%

“…[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 tendon diameter for PCL reconstruction generally needs to be more than 8 mm, but autologous tendons are relatively smaller, which might lead to limited clinical application in this situation. [13] …”

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%

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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%