Allograft Use in Hand Surgery - 'Off the Shelf' Tendon Reconstruction: A Scoping Review.

Tendon grafting is standard for treating tendon defects. Allografts are popular in cruciate ligament reconstruction but not yet in upper limb tendon reconstruction. A scoping review was conducted to map the existing practice of allograft use in hand surgery for tendon reconstruction and identify gaps in knowledge for future research. Two independent reviewers searched MEDLINE and SCOPUS databases for studies on upper limb tendon reconstruction using tendon allografts until June 2022. Eligible studies included controlled randomised clinical trials, cohort, case-control, cross-sectional, or case report and series studies conducted in English and enrolling patients who underwent tendon allograft reconstruction in the upper limb. Screening for eligibility was done by both reviewers, who reached a consensus through discussion, with no exclusion based on poor methodological quality. Data charting included study title, patients' demographics and outcomes, complications, and follow-up period. The database search found 6 eligible articles with a total of 116 patients and 148 allografts used for reconstruction. Of the studies that looked at functional outcomes, 72.9% of patients had 'good' or 'fair' results, while 25.8% were classed as 'poor'. All of the patients assessed for subjective outcomes were at least partially/fairly satisfied with the allograft. This scoping review has indicated that the utilisation of tendon allografts in the upper limb can potentially be a promising approach for tendon reconstruction, especially in cases of severe trauma or salvage. However, further research is needed to comprehensively assess efficacy, long-term outcomes, complications, postoperative rehabilitation protocols, and comparative effectiveness against autograft tendon reconstruction.