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A Systematic Review of Failed Anterior Cruciate Ligament Reconstruction With Autograft Compared With Allograft in Young Patients
| Content Provider | Scilit |
|---|---|
| Author | Wasserstein, David Sheth, Ujash Cabrera, Alison Spindler, Kurt P. |
| Copyright Year | 2015 |
| Abstract | Context: : The advantages of allograft anterior cruciate ligament reconstruction (ACLR), which include shorter surgical time, less postoperative pain, and no donor site morbidity, may be offset by a higher risk of failure. Previous systematic reviews have inconsistently shown a difference in failure prevalence by graft type; however, such reviews have never been stratified for younger or more active patients. Objective: : To determine whether there is a different ACLR failure prevalence of autograft compared with allograft in young, active patients. Data Sources: : EMBASE, MEDLINE, Cochrane trials registry. Study Selection: : Comparative studies of allograft versus autograft primary ACL reconstruction in patients 12 points, collegiate or semiprofessional athletes). Study Design: : Systematic review with meta-analysis. Level of Evidence: : Level 3. Data Extraction: : Manual extraction of available data from eligible studies. Quantitative synthesis of failure prevalence and Lysholm score (outcomes in ≥3 studies) and $I^{2}$ test for heterogeneity. Assessment of study quality using CLEAR NPT and Newcastle-Ottawa Scale (NOS). Results: : Seven studies met inclusion criteria (1 level 1; 2 level 2, 4 level 3), including 788 patients treated with autograft tissue and 228 with various allografts. The mean age across studies was 21.7 years (64% male), and follow-up ranged between 24 and 51 months. The pooled failure prevalence was 9.6% (76/788) for autografts and 25.0% (57/228) for allografts (relative risk, 0.36; 95% CI, 0.24-0.53; P < 0.00001; $I^{2}$ = 16%). The number needed to benefit to prevent 1 failure by using autograft was 7 patients (95% CI, 5-10). No difference between hamstrings autograft and patella tendon autograft was noted. Lysholm score was reported in 3 studies and did not differ between autograft and allograft. Conclusion: : While systematic reviews comparing allograft and autograft ACLR have been equivocal, this is the first review to examine young and active patients in whom allograft performs poorly. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4482307/pdf |
| Ending Page | 216 |
| Page Count | 10 |
| Starting Page | 207 |
| ISSN | 19417381 |
| e-ISSN | 19410921 |
| DOI | 10.1177/1941738115579030 |
| Journal | Sports Health: A Multidisciplinary Approach |
| Issue Number | 3 |
| Volume Number | 7 |
| Language | English |
| Publisher Date | 2015-05-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Sports Health: A Multidisciplinary Approach Sport Sciences Anterior Cruciate Ligament Reconstruction Young Age |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Physical Therapy, Sports Therapy and Rehabilitation |
