The results of anterior cruciate ligament reconstruction with allograft versus autograft: a systematic review and meta-analysis.

PURPOSE

Anterior cruciate ligament (ACL) injury is a common sports-related injury that often requires surgical intervention. The two main types of grafts used in ACL reconstruction are autografts and allografts. Two types of transplants have their own advantages in different aspects, so the choice of graft type is a matter of ongoing debate among orthopedic surgeons. The purpose of this systematic review and meta-analysis is to compare the results of ACL reconstruction using allograft versus autograft.

METHODS

The Embase and PubMed databases were searched for clinical trial literature from January 1, 2000, to July 19, 2023, which met the individual inclusion criteria, for a meta-analysis of objective and subjective outcomes of the knee joint. Using random effects model, risk of bias was assessed using the Cochrane Collaboration's tools.

RESULTS

Thirteen studies and total of 1299 patients were included in the analysis. The pooled mean difference (MD) of subjective IKDC score was 2.14 (95% CI:1.43-2.85). The pooled MD of Lysholm score was 0.38 (95% CI:-1.25-2.02). The pooled MD of Tegner score was 0.23 (95% CI:0.03-0.43). The pooled relative risk (RR) of Lachman test was 1.32 (95% CI:0.95-1.82). The pooled RR of pivot shift test was 1.12 (95% CI:1.00-1.25). The pooled RR of objective IKDC was 1.03 (95% CI:1.01-1.05). In general, statistically significant differences in favor of autograft were observed for Subjective International Knee Documentation Committee score, Tegner score, pivot shift test and Objective International Knee Documentation Committee score, as for the Lysholm score and Lachman test there is no statistical differences between the two.

CONCLUSION

From a majority of the outcome measures, autografts appear to have a slightly better effect compared to allografts. However, these slight differences in scores may not be reflected in clinical outcomes, indicating that there is not much superiority or inferiority between the two from the perspective of clinical outcomes. Therefore, in other fields such as humanities and economics, they are important factors for doctors to make choices in clinical practice.