Allografts and Autografts in Primary Hip Labral Reconstruction Result in Improved Postoperative Outcomes, With Autografts Demonstrating Lower Revision and Complication Rates: A Systematic Review.
Colton C Mowers, Justin T Childers, Benjamin T Lack, Ariel S Hus, Matthew T McKinley, Garrett R Jackson, Steven F DeFroda
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引用次数: 0
Abstract
Purpose: To compare patient-reported outcomes, complications and revision rates following the use of autograft versus allograft for primary arthroscopic hip labral reconstruction.
Methods: The PubMed, Scopus, and Embase databases were queried following the 2020 PRISMA guidelines to identify human clinical studies reporting outcomes following primary arthroscopic hip labral reconstruction with a minimum follow-up of two years. Studies that did not report graft type or outcomes were excluded. Studies were separated into two cohorts based on graft type, allograft or autograft. The mean delta (change from preoperative to postoperative values) was calculated for each patient reported outcome score and compared between cohorts. The MINORS criteria was used to evaluate bias.
Results: Seventeen studies (allograft=9 studies, autograft=11 studies) of 756 patients were included. Mean follow-up for the allograft cohort was 37 months (mean range, 25.5-66.1) compared to 38.3 months (mean range, 25.4-80.8) for the autograft cohort. At final follow-up, delta values for modified Harris Hip Score ranged from 18.2-34 (allograft) versus 9.4-31.7 (autograft), HOS-Sports scale ranged from 24.2-39.7 (allograft) versus 21.4-41.3 (autograft), Visual Analog Pain scale ranged from -5.7 to -1.7 (allograft) versus -5.7 to -2.4 (autograft), and delta values for the Non-Arthritic Hip score ranged from 19.7-31.3 (allograft) versus 16.6-35.4 (autograft). Postoperative complication rates ranged from 0.0% to 17.6% (allograft) versus 0.0% to 9.1% (autograft). The most common complication for the allograft cohort was numbness (n=2) versus heterotopic ossification (n=6) in the autograft cohort. Rates of arthroscopic revision surgery were 0.0% to 5.9% (allograft) versus 0.0% to 9.1% (autograft), while conversion to total hip arthroplasty ranged from 0.0% to 17.6% (allograft) versus 0.0% to 8.3% (autograft).
Conclusion: The use of allografts and autografts in primary hip labral reconstruction results in improved postoperative outcomes. However, allografts were associated with higher rates of complications with worse graft survivorship.
Level of evidence: IV, Systematic Review of Level of Evidence III-IV Studies.
期刊介绍:
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.