Hamstring Tendon Autograft versus Hamstring Tendon Allograft in Anterior Cruciate Ligament Reconstruction by Arthroscopy: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 LIbin , LIUXue-long , SUQi ,  XUGuo-kang

Department of Orthopedics, The First People's Hospital of Fuyang District, Hangzhou 311403, China;

Corresponding author：

XUGuo-kang, Email: 17776873@qq.com

Keywords：

Autologous hamstring tendon; Allograft tendon; Anterior cruciate ligament; systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20150161

Video：

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Objective To systematically review the efficacy of hamstring tendon autograft versus hamstring tendon allograft in anterior cruciate ligament reconstruction by arthroscopy. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 2, 2015), CNKI, VIP, WanFang Data were electronically searched to collect randomized controlled trials (RCTs) about hamstring tendon autograft versus hamstring tendon allograft in anterior cruciate ligament reconstruction by arthroscopy from inception to February 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 6 RCTs involving 535 knees were included. The results of meta-analysis showed that:(1) Postoperative physical outcomes:There were no significant differences between the hamstring tendon autograft group and the hamstring tendon allograft group in positive rate of Lachman test (RR=1.25, 95%CI 0.92 to 1.71, P=0.15) and positive rate of Pivot shift test (RR=1.04, 95%CI 0.93 to 1.17, P=0.47) at 1 year postoperatively. (2) Postoperative functional recovery outcomes:There were no significant differences between both groups in KT-1000/2000 measurement (MD=-0.79, 95%CI -1.78 to 1.20, P=0.12), abnormal rate of IKDC scores (RR=1.03, 95%CI 0.90 to 1.1, P=0.42) and Lysholm scores (MD=0.23, 95%CI -1.86 to 2.33, P=0.83) at 1 year postoperatively. Conclusion Hamstring tendon autograft and hamstring tendon allograft have similar efficacy in anterior cruciate ligament reconstruction by arthroscopy. Due to limited quality and quantity of the included studies, more large-scale and high quality studies are needed to verify the above conclusion.

Citation： LIbin, LIUXue-long, SUQi, XUGuo-kang. Hamstring Tendon Autograft versus Hamstring Tendon Allograft in Anterior Cruciate Ligament Reconstruction by Arthroscopy: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(8): 967-973. doi: 10.7507/1672-2531.20150161 Copy

1.	O'Neill DB. Arthroscopically assisted reconstruction of the anterior cruciate ligament, A follow-up report. J Bone Joint Surg Am, 2001, 83-A(9):1329-1332.
2.	Harner CD, Irrgang JJ, Paul J, et al. Loss of motion after anterior cruciate ligament reconstruction. Am J Sports Med, 2012, 40(1):108-113.
3.	Seon J, Song E, Park S, et al. Osteoarthritis after anterior cruciate ligament reconstruction using a patellar tendon autograft. Int Orthop, 2006, 30(2):94-98.
4.	Breitfuss H, Frohlich R, Povacz P, et al. The tendon defect after anterior cruciate ligament reconstruction using the midthird patellar tendon-a problem for the patellofemoral joint. Knee Surg Sports Traumatol Arthrosc, 1996, 3(4):194-198.
5.	Indelicato PA, Talley C. Allograft tissue in the reconstruction of the anterior cruciate ligament. J Sports Traumatol Relat Res, 1995, 4(3):185-191.
6.	Jackson DW, Grood ES, Goldstein JD, et al. A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model. Am J Sports Med, 1993, 21(2):176-185.
7.	Asselmeier MA, Caspari RB, Bottenfield S, et al. A review of allograft processing and sterilization techniques and their role in transmission of the human immunodeficiency virus. Am J Sports Med, 1993, 21(2):170-175.
8.	Harner CD, Fu FH. The immune response to allograft ACL reconstruction. Am J Knee Surg, 1993, 23(6):45-46.
9.	Stringham DR, Pelmas CJ, Burks RT, et al. Comparison of anterior cruciate ligament reconstructions using patellar tendon autograft or allograft. Arthroscopy, 1996, 12(4):414-421.
10.	Shino K, Inoue M, Horibe S, et al. Reconstruction of the anterior cruciate ligament using allogeneic tendon:Long-term followup. Am J Sports Med, 1990, 18(5):457-465.
11.	Shelton W, Papendick L, Dukes A, et al. Autograft versus allograft anterior cruciate ligament reconstruction. Arthroscopy, 1997, 14(4):446-449.
12.	Kleipool AEB, Zijl JAC, Willems WJ, et al. Arthroscopic anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft or autograft. Knee Surg Sports Traumatol Arthrosc, 1998, 6(4):224-230.
13.	Edgar CM, Zimmer S, Kakar S, et al. Prospective comparison of auto and allograft hamstring tendon constructs for ACL reconstruction. Clin Orthop Relat Res, 2008, 466(9):2238-2246.
14.	Jung HN, Seung RY, Sang JS, et al. Comparison between hamstring autograft and free tendon Achilles allograft:minimum 2-year follow-up after anterior cruciate ligament reconstruction using Endo Button and Intra-fix. Knee Surg Sports Traumatol Arthrosc, 2011, 19(4):816-822.
15.	Sun K, Zhang J, Wang Y, et al. Arthroscopic anterior cruciate ligament reconstruction with at least 2.5 years' follow-up comparing hamstring tendon autograft and irradiated allograft. Arthroscopy, 2011, 27(9):1195-1202.
16.	Sun K, Zhang J, Wang Y, et al. Arthroscopic reconstruction of the anterior cruciate ligament with hamstring tendon autograft and fresh-frozen allograft:a prospective, randomized controlled study. Am J Sports Med, 2011, 39(7):1430-1438.
17.	Keith WL, Stephen M, Howell MD, et al. The Effect of Graft Tissue on Anterior Cruciate Ligament Outcomes:A Multicenter, Prospective, Randomized Controlled Trial Comparing Autograft Hamstrings With Fresh-Frozen Anterior Tibialis Allograft. Arthroscopy, 2012, 28(8):1079-86.
18.	刘红光, 陈述祥, 赵崇达, 等. 膝关节镜下自体胭绳肌腱和同种异体肌腱移植重建前交叉韧带对比观察. 中国骨伤, 2008, 21(2):267-269.
19.	Lee JH, Bae DK, Song SJ, et al. Comparison of clinical results and second-look arthroscopy findings after arthroscopic anterior cruciate ligament reconstruction using 3 different types of grafts. Arthroscopy, 2010, 26(1):41-49.
20.	Magnussen RA, Carey JL, Spindler KP, et al. Does autograft choice determine intermediate-term outcome of ACL reconstruction? Knee Surg Sports Traumatol Arthrosc, 2011, 19(3):462-472.
21.	Mascarenhas R, Tranovich M, Karpie JC, et al. Patellar tendon anterior cruciate ligament reconstruction in the high-demand patient:evaluation of autograft versus allograft reconstruction. Arthroscopy, 2010, 26(9 Suppl):S58-S66.
22.	Foster TE, Wolfe BL, Ryan S, et al. Does the graft source really matter in the outcome of patients undergoing anterior cruciate ligament reconstruction? An evaluation of autograft versus allogrft reconstruction results:a systematic review. Am J Sports Med, 2010, 38(1):189-199.
23.	Guo L, Yang L, Duan XJ, et al. Anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft:comparison of autograft, fresh-frozen allograft, and gamma-irradiated allograft. Arthroscopy, 2012, 28(2):211-217.

1. O'Neill DB. Arthroscopically assisted reconstruction of the anterior cruciate ligament, A follow-up report. J Bone Joint Surg Am, 2001, 83-A(9):1329-1332.
2. Harner CD, Irrgang JJ, Paul J, et al. Loss of motion after anterior cruciate ligament reconstruction. Am J Sports Med, 2012, 40(1):108-113.
3. Seon J, Song E, Park S, et al. Osteoarthritis after anterior cruciate ligament reconstruction using a patellar tendon autograft. Int Orthop, 2006, 30(2):94-98.
4. Breitfuss H, Frohlich R, Povacz P, et al. The tendon defect after anterior cruciate ligament reconstruction using the midthird patellar tendon-a problem for the patellofemoral joint. Knee Surg Sports Traumatol Arthrosc, 1996, 3(4):194-198.
5. Indelicato PA, Talley C. Allograft tissue in the reconstruction of the anterior cruciate ligament. J Sports Traumatol Relat Res, 1995, 4(3):185-191.
6. Jackson DW, Grood ES, Goldstein JD, et al. A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model. Am J Sports Med, 1993, 21(2):176-185.
7. Asselmeier MA, Caspari RB, Bottenfield S, et al. A review of allograft processing and sterilization techniques and their role in transmission of the human immunodeficiency virus. Am J Sports Med, 1993, 21(2):170-175.
8. Harner CD, Fu FH. The immune response to allograft ACL reconstruction. Am J Knee Surg, 1993, 23(6):45-46.
9. Stringham DR, Pelmas CJ, Burks RT, et al. Comparison of anterior cruciate ligament reconstructions using patellar tendon autograft or allograft. Arthroscopy, 1996, 12(4):414-421.
10. Shino K, Inoue M, Horibe S, et al. Reconstruction of the anterior cruciate ligament using allogeneic tendon:Long-term followup. Am J Sports Med, 1990, 18(5):457-465.
11. Shelton W, Papendick L, Dukes A, et al. Autograft versus allograft anterior cruciate ligament reconstruction. Arthroscopy, 1997, 14(4):446-449.
12. Kleipool AEB, Zijl JAC, Willems WJ, et al. Arthroscopic anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft or autograft. Knee Surg Sports Traumatol Arthrosc, 1998, 6(4):224-230.
13. Edgar CM, Zimmer S, Kakar S, et al. Prospective comparison of auto and allograft hamstring tendon constructs for ACL reconstruction. Clin Orthop Relat Res, 2008, 466(9):2238-2246.
14. Jung HN, Seung RY, Sang JS, et al. Comparison between hamstring autograft and free tendon Achilles allograft:minimum 2-year follow-up after anterior cruciate ligament reconstruction using Endo Button and Intra-fix. Knee Surg Sports Traumatol Arthrosc, 2011, 19(4):816-822.
15. Sun K, Zhang J, Wang Y, et al. Arthroscopic anterior cruciate ligament reconstruction with at least 2.5 years' follow-up comparing hamstring tendon autograft and irradiated allograft. Arthroscopy, 2011, 27(9):1195-1202.
16. Sun K, Zhang J, Wang Y, et al. Arthroscopic reconstruction of the anterior cruciate ligament with hamstring tendon autograft and fresh-frozen allograft:a prospective, randomized controlled study. Am J Sports Med, 2011, 39(7):1430-1438.
17. Keith WL, Stephen M, Howell MD, et al. The Effect of Graft Tissue on Anterior Cruciate Ligament Outcomes:A Multicenter, Prospective, Randomized Controlled Trial Comparing Autograft Hamstrings With Fresh-Frozen Anterior Tibialis Allograft. Arthroscopy, 2012, 28(8):1079-86.
18. 刘红光, 陈述祥, 赵崇达, 等. 膝关节镜下自体胭绳肌腱和同种异体肌腱移植重建前交叉韧带对比观察. 中国骨伤, 2008, 21(2):267-269.
19. Lee JH, Bae DK, Song SJ, et al. Comparison of clinical results and second-look arthroscopy findings after arthroscopic anterior cruciate ligament reconstruction using 3 different types of grafts. Arthroscopy, 2010, 26(1):41-49.
20. Magnussen RA, Carey JL, Spindler KP, et al. Does autograft choice determine intermediate-term outcome of ACL reconstruction? Knee Surg Sports Traumatol Arthrosc, 2011, 19(3):462-472.
21. Mascarenhas R, Tranovich M, Karpie JC, et al. Patellar tendon anterior cruciate ligament reconstruction in the high-demand patient:evaluation of autograft versus allograft reconstruction. Arthroscopy, 2010, 26(9 Suppl):S58-S66.
22. Foster TE, Wolfe BL, Ryan S, et al. Does the graft source really matter in the outcome of patients undergoing anterior cruciate ligament reconstruction? An evaluation of autograft versus allogrft reconstruction results:a systematic review. Am J Sports Med, 2010, 38(1):189-199.
23. Guo L, Yang L, Duan XJ, et al. Anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft:comparison of autograft, fresh-frozen allograft, and gamma-irradiated allograft. Arthroscopy, 2012, 28(2):211-217.

Chinese Journal of Evidence-Based Medicine

Hamstring Tendon Autograft versus Hamstring Tendon Allograft in Anterior Cruciate Ligament Reconstruction by Arthroscopy: A Systematic Review

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