Autograft Demonstrates Superior Outcomes for Revision Anterior Cruciate Ligament Reconstruction When Compared With Allograft: A Systematic Review.

Autor:	Belk JW; Department of Orthopaedics, University of Colorado School of Medicine, Aurora, Colorado, USA., Littlefield CP; Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA., Smith JH; Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA., McCulloch PC; Department of Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA., McCarty EC; Department of Orthopaedics, University of Colorado School of Medicine, Aurora, Colorado, USA., Frank RM; Department of Orthopaedics, University of Colorado School of Medicine, Aurora, Colorado, USA., Kraeutler MJ; Department of Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, Texas, USA.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2024 Mar; Vol. 52 (3), pp. 859-867. Date of Electronic Publication: 2023 Mar 03.
DOI:	10.1177/03635465231152232
Abstrakt:	Background: Multiple studies have compared outcomes among patients undergoing revision anterior cruciate ligament reconstruction (ACLR) with autograft versus allograft, but these data are inconsistently reported and long-term outcomes depending on graft type are yet to be determined. Purpose: To perform a systematic review of clinical outcomes after revision ACLR (rACLR) with autograft versus allograft. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was performed by searching PubMed, the Cochrane Library, and Embase to identify studies that compared the outcomes of patients undergoing rACLR with autograft versus allograft. The search phrase used was autograft allograft revision anterior cruciate ligament reconstruction . Graft rerupture rates, return-to-sports rates, anteroposterior laxity, and patient-reported outcome scores (subjective International Knee Documentation Committee, Tegner, Lysholm, and Knee injury and Osteoarthritis Outcome Score) were evaluated. Results: Eleven studies met inclusion criteria, including 3011 patients undergoing rACLR with autograft (mean age, 28.9 years) and 1238 patients undergoing rACLR with allograft (mean age, 28.0 years). Mean follow-up was 57.3 months. The most common autograft and allograft types were bone-patellar tendon-bone grafts. Overall, 6.2% of patients undergoing rACLR experienced graft retear, including 4.7% in the autograft group and 10.2% in the allograft group ( P < .0001). Among studies that reported return-to-sports rates, 66.2% of patients with an autograft returned to sports as opposed to 45.3% of patients with an allograft ( P = .01). Two studies found significantly greater postoperative knee laxity in the allograft group as compared with the autograft group ( P < .05). Among all patient-reported outcomes, 1 study found 1 significant difference between groups: patients with an autograft had a significantly higher postoperative Lysholm score when compared with patients with an allograft. Conclusion: Patients undergoing revision ACLR with an autograft can be expected to experience lower rates of graft retear, higher rates of return to sports, and less postoperative anteroposterior knee laxity when compared with patients undergoing revision ACLR with an allograft. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: P.C.M. has received research support from Arthrex and Smith+Nephew, consulting fees from Arthrex, honoraria from Vericel, and support for education from MedInc of Texas. E.C.M. has received consulting fees from Biomet, DePuy Synthes, Pacira Therapeutics, Flexion Therapeutics, and Medical Device Business Services; research support from Arthrex, Breg, DJ Orthopedics, Mitek, Ossur, and Smith+Nephew; support for education from Gemini Mountain Medical; and royalties from Biomet, Elsevier, and Zimmer. R.M.F. has received research support from Smith+Nephew and Arthrex; consulting fees from Allosource, Arthrex, and JRF; speaking fees from Ossur; support for education from Arthrex, Gemini Mountain Medical, and Pinnacle Inc; and publishing royalties from Elsevier. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Databáze:	MEDLINE
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