Abstract
BackgroundCritically evaluation and summarization for the outcomes between autografts and artificial grafts using in anterior cruciate ligament (ACL) reconstruction have not been performed currently. The purpose of this study is to compare the clinical outcomes between artificial ligaments and autografts at a short- to mid-term follow-up.MethodsA computerized search of the databases was conducted including Medline, Embase, and the Cochrane library. Only prospective or retrospective comparative studies with a minimum 2-year follow-up and a minimum sample size of 15 for each group were considered for inclusion. Two independent reviewers performed data extraction and methodological quality assessment. A Mantel-Haenszel analysis was used for pooling of results. Sensitivity analysis was performed in order to maintain the stability of results.ResultsSeven studies were included in this study. The total sample size was 403 (autograft group: 206 patients; synthetic graft group: 197 patients). Four studies were randomized controlled trials. Two studies were retrospective comparative studies and one study was non-randomized prospective comparative study. In terms of instrumented laxity, patient-oriented outcomes and complications, no significant difference was occurred between new artificial ligaments and autografts. But the results of IKDC grades and instrumented laxity were worsen in early artificial ligaments compared to autografts.ConclusionsThe outcomes of new generation of artificial ligaments are similar to autografts at a short- to mid-term follow-up. However, the early artificial ligaments are not suggested for ACL reconstruction compared to autografts.
Highlights
Evaluation and summarization for the outcomes between autografts and artificial grafts using in anterior cruciate ligament (ACL) reconstruction have not been performed currently
Two studies were conducted in a North American country, and three studies were conducted in a European country
With regard to knee laxity, ACL reconstruction with early artificial grafts had obviously poorer knee laxity from those with autografts while new artificial grafts showed no significant difference with autografts
Summary
Evaluation and summarization for the outcomes between autografts and artificial grafts using in anterior cruciate ligament (ACL) reconstruction have not been performed currently. Anterior cruciate ligament (ACL) injury is a main cause of recurrent knee instability and may result in secondary damages to other structures of the knee, such as meniscal tears and articular cartilage degeneration [1]. ACL reconstruction is the gold-standard surgical technique for ACL injury [2]. Reconstruction can be performed by using autograft, allograft or synthetic graft [3]. Autograft is a well-recognized and widely used material for ACL reconstruction due to a good graft stability and a well return to high-level sports [4]. Bonepatella tendon-bone (BPTB) autograft has historically served as the gold standard for ACL reconstruction based on widespread global use and as the first autograft option.
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