Autograft versus Allograft Tendon for Posterior Cruciate Ligament Single-bundle Reconstruction: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 XIONGWei ¹ , LIUJia-guo ¹ , LUOBin ¹ , ZHANGJin-song ¹ , ZHAOMeng ¹ , ZHANGChao ²

1. Department of Orthopedics and Trauma, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China;
2. Center for Evidence-based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China;

Corresponding?author：

Keywords：

Posterior cruciate ligament; Reconstruction; Autograft; Allograft; Meta-analysis

DOI：

10.7507/1672-2531.20160089

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Objective To systematically review the effects of autograft versus allograft tendon for posterior cruciate ligament single-bundle reconstruction. Methods Databases including PubMed, The Cochrane Library (Issue 3, 2015), EMbase, CBM, CNKI, VIP and WanFang Data were searched from inception to August 2015, to collect randomized controlled trials, clinical controlled trials and cohort studies of autograft tendon versus allograft tendon for posterior cruciate ligament single-bundle reconstruction. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed using RevMan 5.3 software. Results A total of 7 cohort studies involving 376 patients who had undergone the arthroscopic transtibial single-bundle PCL reconstruction were included. The results of meta-analysis indicated that no significant differences were found between the autograft group and the allograft group in Lysholm score (MD=-0.54, 95%CI -2.36 to 1.27, P=0.56), Tegner score (MD=-0.04, 95%CI -0.88 to 0.80, P=0.93), IKDC objective score (OR=1.31, 95%CI 0.68 to 2.53, P=0.41) and posterior translation side-to-side difference (SMD=-0.15, 95%CI -0.37 to 0.07, P=0.18). However, patients in the allograft group had a longer duration of fever when compared with the autograft group patients (MD=-3.55, 95%CI-5.61 to -1.49, P=0.0007). Conclusion Current evidence shows that autograft tendon and allograft tendon tibial have similar effects in PCL single-bundle reconstruction, though there is a longer duration of fever in patients with allograft. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： XIONGWei, LIUJia-guo, LUOBin, ZHANGJin-song, ZHAOMeng, ZHANGChao. Autograft versus Allograft Tendon for Posterior Cruciate Ligament Single-bundle Reconstruction: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(5): 579-584. doi: 10.7507/1672-2531.20160089 Copy

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2.	Voos JE, Mauro CS, Wente T, et al. Posterior cruciate ligament: anatomy, biomechanics, and outcomes. Am J Sports Med, 2012, 40(1): 222-231.
3.	LaPrade CM, Civitarese DM, Rasmussen MT, et al. Emerging Updates on the Posterior Cruciate Ligament: A Review of the Current Literature. Am J Sports Med, 2015, 43(2): 3077-3092.
4.	Ahn JH, Yoo JC, Wang JH. Posterior cruciate ligament reconstruction: double-loop hamstring tendon autograft versus Achilles tendon allograft——clinical results of a minimum 2-year follow-up. Arthroscopy, 2005, 21(8): 965-969.
5.	Li B, Wang JS, He M, et al. Comparison of hamstring tendon autograft and tibialis anterior allograft in arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2015, 23(10): 3077-3084.
6.	Sun X, Zhang J, Qu X, et al. Arthroscopic posterior cruciate ligament reconstruction with allograft versus autograft. Arch Med Sci, 2015, 11(2): 395-401.
7.	王瑞, 徐斌, 徐洪港. 關節鏡下單束重建后交叉韌帶臨床療效分析. 安徽醫藥, 2013, 17(1): 55-57.
8.	莫成敏, 林秋喜. 自體腘繩肌腱、同種異體肌腱重建后交叉韌帶的療效比較. 中國醫藥導報, 2015, 12(10): 98-102.
9.	黃華揚, 李憑躍, 張余. 關節鏡下自體與異體骨-髕腱-骨重建后交叉韌帶的臨床對比研究. 中華創傷骨科雜志, 2010, 12(4): 339-342.
10.	Wang CJ, Chan YS, Weng LH, et al. Comparison of autogenous and allogenous posterior cruciate ligament reconstructions of the knee. Injury, 2004, 35(12): 1279-1285.
11.	曾憲濤, 莊麗萍, 楊宗國, 等. Meta分析系列之七: 非隨機實驗性研究、診斷性試驗及動物實驗的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(6): 496-499.
12.	曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
13.	Hudgens JL, Gillette BP, Krych AJ, et al. Allograft versus autograft in posterior cruciate ligament reconstruction: an evidence-based systematic review. J Knee Surg, 2013, 26(2): 109-115.
14.	Kim YM, Lee CA, Matava MJ. Clinical results of arthroscopic single-bundle transtibial posterior cruciate ligament reconstruction: a systematic review. Am J Sports Med, 2011, 39(2): 425-434.
15.	H?her J, Scheffler S, Weiler A. Graft choice and graft fixation in PCL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2003, 11(5): 297-306.
16.	Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint.Anatomical, functional and experimental analysis. Clin Orthop Relat Res, 1975, Jan-Feb(106): 216-231.
17.	Lin YC, Chen SK, Liu TH, et al. Arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction using patellar tendon graft compared with hamstring tendon graft. Arch Orthop Trauma Surg, 2013, 133(4): 523-530.
18.	敖英芳, 程序, 胡躍林, 等. 后交叉韌帶重建后翻修原因分析. 中華外科雜志, 2009, 47(7): 541-544.
19.	Song JG, Kim HJ, Han JH, et al. Clinical outcome of posterior cruciate ligament reconstruction with and without remnant preservation. Arthroscopy, 2015, 31(9): 1796-1806.
20.	Panchal HB, Sekiya JK. Open tibial inlay versus arthroscopic transtibial posterior cruciate ligament reconstructions. Arthroscopy, 2011, 27(9): 1289-1295.
21.	Yanke AB, Bell R, Lee A, et al. The biomechanical effects of 1.0 to 1.2 Mrad of γ irradiation on human bone-patellar tendon-bone allografts. Am J Sports Med, 2013, 41(4): 835-840.
22.	Sun K, Zhang J, Wang Y, et al. A prospective randomized comparison of irradiated and non-irradiated hamstring tendon allograft for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2012, 20(1): 187-194.
23.	Rihn JA, Irrgang JJ, Chhabra A, et al. Does irradiation affect the clinical outcome of patellar tendon allograft ACL reconstruction? Knee Surg Sports Traumatol Arthrosc, 2006, 14(9): 885-896.

1. Levy BA, Fanelli GC, Miller MD, et al. Advances in posterior cruciate ligament reconstruction. Instr Course Lect, 2015, 64(48): 543-554.
2. Voos JE, Mauro CS, Wente T, et al. Posterior cruciate ligament: anatomy, biomechanics, and outcomes. Am J Sports Med, 2012, 40(1): 222-231.
3. LaPrade CM, Civitarese DM, Rasmussen MT, et al. Emerging Updates on the Posterior Cruciate Ligament: A Review of the Current Literature. Am J Sports Med, 2015, 43(2): 3077-3092.
4. Ahn JH, Yoo JC, Wang JH. Posterior cruciate ligament reconstruction: double-loop hamstring tendon autograft versus Achilles tendon allograft——clinical results of a minimum 2-year follow-up. Arthroscopy, 2005, 21(8): 965-969.
5. Li B, Wang JS, He M, et al. Comparison of hamstring tendon autograft and tibialis anterior allograft in arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2015, 23(10): 3077-3084.
6. Sun X, Zhang J, Qu X, et al. Arthroscopic posterior cruciate ligament reconstruction with allograft versus autograft. Arch Med Sci, 2015, 11(2): 395-401.
7. 王瑞, 徐斌, 徐洪港. 關節鏡下單束重建后交叉韌帶臨床療效分析. 安徽醫藥, 2013, 17(1): 55-57.
8. 莫成敏, 林秋喜. 自體腘繩肌腱、同種異體肌腱重建后交叉韌帶的療效比較. 中國醫藥導報, 2015, 12(10): 98-102.
9. 黃華揚, 李憑躍, 張余. 關節鏡下自體與異體骨-髕腱-骨重建后交叉韌帶的臨床對比研究. 中華創傷骨科雜志, 2010, 12(4): 339-342.
10. Wang CJ, Chan YS, Weng LH, et al. Comparison of autogenous and allogenous posterior cruciate ligament reconstructions of the knee. Injury, 2004, 35(12): 1279-1285.
11. 曾憲濤, 莊麗萍, 楊宗國, 等. Meta分析系列之七: 非隨機實驗性研究、診斷性試驗及動物實驗的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(6): 496-499.
12. 曾憲濤, 劉慧, 陳曦, 等. Meta分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
13. Hudgens JL, Gillette BP, Krych AJ, et al. Allograft versus autograft in posterior cruciate ligament reconstruction: an evidence-based systematic review. J Knee Surg, 2013, 26(2): 109-115.
14. Kim YM, Lee CA, Matava MJ. Clinical results of arthroscopic single-bundle transtibial posterior cruciate ligament reconstruction: a systematic review. Am J Sports Med, 2011, 39(2): 425-434.
15. H?her J, Scheffler S, Weiler A. Graft choice and graft fixation in PCL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2003, 11(5): 297-306.
16. Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint.Anatomical, functional and experimental analysis. Clin Orthop Relat Res, 1975, Jan-Feb(106): 216-231.
17. Lin YC, Chen SK, Liu TH, et al. Arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction using patellar tendon graft compared with hamstring tendon graft. Arch Orthop Trauma Surg, 2013, 133(4): 523-530.
18. 敖英芳, 程序, 胡躍林, 等. 后交叉韌帶重建后翻修原因分析. 中華外科雜志, 2009, 47(7): 541-544.
19. Song JG, Kim HJ, Han JH, et al. Clinical outcome of posterior cruciate ligament reconstruction with and without remnant preservation. Arthroscopy, 2015, 31(9): 1796-1806.
20. Panchal HB, Sekiya JK. Open tibial inlay versus arthroscopic transtibial posterior cruciate ligament reconstructions. Arthroscopy, 2011, 27(9): 1289-1295.
21. Yanke AB, Bell R, Lee A, et al. The biomechanical effects of 1.0 to 1.2 Mrad of γ irradiation on human bone-patellar tendon-bone allografts. Am J Sports Med, 2013, 41(4): 835-840.
22. Sun K, Zhang J, Wang Y, et al. A prospective randomized comparison of irradiated and non-irradiated hamstring tendon allograft for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc, 2012, 20(1): 187-194.
23. Rihn JA, Irrgang JJ, Chhabra A, et al. Does irradiation affect the clinical outcome of patellar tendon allograft ACL reconstruction? Knee Surg Sports Traumatol Arthrosc, 2006, 14(9): 885-896.

Chinese Journal of Evidence-Based Medicine

Autograft versus Allograft Tendon for Posterior Cruciate Ligament Single-bundle Reconstruction: A Meta-analysis

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