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Sports Health published a meta-analysis in the January-February 2010 issue. It was entitled: Clinical Outcomes After Anterior Cruciate Ligament Reconstruction: A Meta-Analysis of Autograft Versus Allograft Tissue.

Although autografts are much more commonly used for ACL reconstruction, the comparative studies of the two are very limited. The research team searched exhaustively to find studies to qualify for inclusion. After reviewing 5000 studies, the researchers found 576 studies that warranted further review. When all was said and done, 56 studies were deemed to meet every aspect of their criteria, one of which directly compared both autograft and allograft reconstruction.

The meta analysis compared the following outcome measures: positive Lachman test, positive pivot-shift test, IKDC grade C or D, graft failure, and joint laxity as measured by a KT-1000 arthrometer.

In a comparison of all the studies, the only statistically significant difference was that allograft patients presented with increased joint laxity when measured by the KT-1000 arthrometer compared with autograft patients.

While the other negative outcome measures proportions were larger for autograft than allograft, statistical analysis revealed that these differences were not statistically significant.

So based upon the available data, the researchers concluded that patients who undergo allograft ACL reconstruction may have more joint laxity as measured by the KT-1000 arthrometer compared to patients who undergo autograft ACL reconstruction. They go on to further recognize that a large multicenter randomized clinical trial comparing both is warranted and would be beneficial.

On a final note, I found this particularly interesting – the researchers had this to say in the discussion:

“Furthermore, data suggest that the incidence of osteoarthritis is similar for patients who have sustained an ACL rupture 15 years following injury, regardless of whether or not they undergo reconstruction. 40 It would be important to ascertain if graft type has an influence on the incidence or progression of osteoarthritis following ACL reconstruction.”

This was a significant undertaking and the researchers should be applauded for their efforts to help provide us with the information needed to more accurately instruct and educate those who face the prospect of ACL reconstruction.


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