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Autograft and Nonirradiated Allograft for Anterior Cruciate Ligament Reconstruction Demonstrate Similar Clinical Outcomes and Graft Failure Rates: An Updated Systematic Review

Arthroscopy, Sports Medicine, and Rehabilitation, ISSN: 2666-061X, Vol: 4, Issue: 4, Page: e1513-e1521
2022
  • 11
    Citations
  • 0
    Usage
  • 30
    Captures
  • 0
    Mentions
  • 19
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    11
  • Captures
    30
  • Social Media
    19
    • Shares, Likes & Comments
      19
      • Facebook
        19

Review Description

To perform an updated systematic review comparing the clinical outcomes of autograft versus nonirradiated allograft for anterior cruciate ligament reconstruction (ACLR). A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines by searching PubMed, the Cochrane Library, and Embase to identify comparative studies directly comparing outcomes of primary ACLR with autograft versus nonirradiated allograft with a minimum 2-year follow-up. The search terms used were: “anterior cruciate ligament” AND autograft AND allograft AND (irradiation OR non-irradiated). Patients were evaluated based on graft failure rates, the Objective International Knee Documentation Committee (IKDC) score, anteroposterior laxity, and patient-reported outcomes (Subjective IKDC score, the visual analog scale [VAS], the Cincinnati Knee Rating System, Lysholm, and Tegner scores). Risk of bias was assessed using the ROBINS-I and Cochrane Collaboration’s risk of bias tool for non-randomized and randomized studies, respectively. Sixteen studies (3 Level I, 7 Level II, 6 Level III) met inclusion criteria, including a total of 15,502 patients undergoing ACLR with autograft and 1,577 with nonirradiated allograft. The average follow-up ranged from 24.0 to 132.0 months. Graft failure ranged from 0% to 9.4% of patients in the autograft group and 0% to 26.5% in the allograft group. Two studies showed greater failure rates among younger patients in the allograft group. There were no significant differences between the Objective IKDC score, anteroposterior laxity, or patient-reported outcomes between the groups within any of the included studies ( P >.05). Autograft and nonirradiated allograft for primary ACLR demonstrate similar patient-reported outcomes and graft failure rates. III, systematic review of level I-III studies.

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