Bone Patella Bone allografts show superior outcomes in revision ACL reconstruction: A systematic review and meta-analysis

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2024-10-07 DOI:10.1016/j.knee.2024.09.006

Yuvraj Chhabra , Sarup Saroha , Kamrul Hasan , Raj Thakrar , Akash Patel

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引用次数: 0

Abstract

Backgrounds and Aims

This study explores the impact of allograft selection in revision ACL reconstruction (RACLR). Allografts reduce donor-site morbidity and surgery duration but are costly and may prolong graft integration times. We aimed to assess various allograft subtypes for their efficacy and failure rates in RACLR.

Materials and Methods

Following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and a pre-defined protocol (ID: CRD42023432517), a systematic review of Cochrane Library, Embase, MEDLINE, Web of Science, and Scopus was performed for allograft studies. The primary outcome was failure rate (graft re-rupture/revision). Secondary outcomes included functional scores, infection rates, and return to sport levels. The meta-analysis weighted studies by standard error.

Results

Studies assessing Bone Patella Bone (BPTB), Tibialis Anterior, and Achilles allografts were included. The results indicate non-statistically significant odds ratios when comparing re-rupture rates for BPTB versus both Achilles (OR 3.69) and Tibialis Anterior (OR 1.26) with low or no heterogeneity. Tibialis Anterior displayed a lower failure rate than Achilles (OR 1.26 vs. 3.69). Secondary outcomes favoured BPTB, showing positive KOOS and IKDC scores, while Achilles reported Lysholm scores (83.8 ± 11.3) and 62% return to sport. Tibialis Anterior outcomes included a Lysholm score (92 ± 4.0).

Conclusion

This study provides insights into graft selection for RACLR. BPTB demonstrated favourable graft failure rates compared to Tibialis Anterior and Achilles allografts. No statistically significant differences were observed in other outcomes between subtypes, emphasising the need for standardised reporting in RACLR studies and supporting avenues for future research.

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骨髌骨骨异体移植在前交叉韧带翻修重建中显示出卓越的疗效：系统回顾和荟萃分析。

背景和目的：本研究探讨了前交叉韧带翻修重建术（RACLR）中选择同种异体移植物的影响。同种异体移植物可降低供体部位的发病率并缩短手术时间，但成本高昂且可能延长移植物的整合时间。我们旨在评估各种同种异体移植物亚型在 RACLR 中的疗效和失败率：按照系统综述和荟萃分析首选报告项目（PRISMA）指南和预先确定的方案（ID：CRD42023432517），对 Cochrane 图书馆、Embase、MEDLINE、Web of Science 和 Scopus 中的同种异体移植研究进行了系统综述。主要结果是失败率（移植物再断裂/再植）。次要结果包括功能评分、感染率和恢复运动水平。荟萃分析根据标准误差对研究进行了加权：结果：纳入了评估髌骨（BPTB）、胫骨前端和跟腱同种异体移植的研究。结果显示，在比较髌骨异体移植与跟腱异体移植（OR 3.69）和胫骨前异体移植（OR 1.26）的再断裂率时，两者的几率均无统计学意义，且异质性较低或没有异质性。前胫骨的失败率低于跟腱（OR 1.26 对 3.69）。次要结果显示，BPTB 更受青睐，其 KOOS 和 IKDC 评分均为正值，而跟腱的 Lysholm 评分（83.8 ± 11.3）和运动恢复率均为 62%。胫骨前肌的结果包括 Lysholm 评分（92 ± 4.0）：这项研究为 RACLR 的移植物选择提供了启示。与胫骨前肌和跟腱同种异体移植物相比，BPTB 的移植物失败率较高。亚型之间的其他结果没有统计学意义上的显著差异，这强调了RACLR研究中标准化报告的必要性，并为未来的研究提供了支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.