Autograft or Allograft? Irradiated or Not? A Contrast Between Autograft and Allograft in Anterior Cruciate Ligament Reconstruction: A Meta-analysis
| Autor: | ShuaiYi Wang, Xiangjin Lin, Chi Zhang, Youzhi Cai |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Anterior cruciate ligament reconstruction Anterior cruciate ligament medicine.medical_treatment Bone-Patellar Tendon-Bone Grafting law.invention 03 medical and health sciences Postoperative Complications 0302 clinical medicine Randomized controlled trial law medicine Humans Orthopedics and Sports Medicine Autografts 030222 orthopedics Lysholm Knee Score Anterior Cruciate Ligament Reconstruction business.industry Graft Survival Hamstring Tendons 030229 sport sciences Allografts musculoskeletal system Confidence interval Surgery surgical procedures operative medicine.anatomical_structure Meta-analysis Relative risk business |
| Zdroj: | Arthroscopy: The Journal of Arthroscopic & Related Surgery. 34:3258-3265 |
| ISSN: | 0749-8063 |
| Popis: | Purpose To compare the clinical outcomes and adverse events associated with irradiated and nonirradiated allografts in anterior cruciate ligament (ACL) reconstruction. Methods PubMed, Web of Science, and EMBASE were searched for randomized controlled trials from January 1990 to March 2018 to compare autograft with allograft in ACL reconstruction. Both objective and subjective outcomes of the function and adverse events were meta-analyzed. Two comparisons were summarized: (1) autograft and nonirradiated allograft and (2) autograft and irradiated allograft. The bias risk was based on the Cochrane Handbook for Systematic Reviews of Interventions. The overall risk ratio or weighted mean difference was calculated using a fixed- or random-effects model. Heterogeneity between studies was evaluated by the Q and the I2 statistics. Results Eleven trials were included in this review for meta-analysis. A total of 1,172 patients were involved (465 autograft and 461 nonirradiated allograft; 141 autograft and 138 irradiated allograft patients). The average follow-up varied from 2 to >10 years. The mean patient age varied from 22 to 32.8 years. The total failure rate was 2.5%. Our analyses demonstrated better clinical outcomes in autograft than irradiated allograft, which could be observed clearly through the International Knee Documentation Committee score (3.84; 95% confidence interval [CI], 1.93-5.76; P Conclusions Autograft offered greater advantages in functional outcomes and adverse events than irradiated allograft in ACL reconstruction; however, there were no significant differences between autograft and nonirradiated allograft in ACL reconstruction. Level of Evidence Level II, meta-analysis of Level I and Level II studies. |
| Databáze: | OpenAIRE |
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