Clinical Outcome Of Allograft Versus Autograft For Anterior Cruciate Ligament Reconstruction Under Arthroscopy:a Meta-analysis

BaekgroudsIn recent years, with frequent sports injuries and traffic accidents, theanterior cruciate ligament of the knee injurys also increased. The traditionaltherapy were rest, gypsum or external fixation and rehabilitation exercise, butthe therapy doesn’t restore its normal anatomic relationship, after long termmay lead to instability of the knee, meniscus injury, the wear of articularcartilage degeneration and secondary degenerative arthritis, etc. Anteriorcruciate ligament is one of the most important structure of the static stability ofthe knee joint, it plays a vital role to the stability of the knee joint, both controlknee physical exercise and limit the dual functions of physical movement.With the development of minimally invasive arthroscopic technique,arthroscopic ACL reconstruction technology is mature, the clinical applicationof arthroscopic operation for treatment of anterior cruciate ligament injurywere also more and more. Arthroscopic reconstruction of anterior cruciateligament with little trauma, short operation time, can be processed at thesame time with other merger of intra-articular injury, accurate positioning,quicker postoperative recovery, fewer complications, is currently widely usedall over the world.Aanterior cruciate ligament reconstruction is affected bymany factors,althrough the accuracy and reliability of the operation isimportant,and the selection of graft, fixation and early rehabilitation exercisecan not be ignored, especially graft selection is very important.Despite the popularity of the procedure, there remains a considerable amount ofcontroversy over whether an autograft or an allograft should be used for ACLreconstruction. Until now,a lots of studies systematically reviewed theclinical outcomes of allograft versus autograft for ACL reconstruction,However, there is still considerable controversy regarding the use of allograftsversus autografts in ACL reconstruction.ObjectiveCompare the clinical outcome of allograft versus autograft for anteriorcruciate ligament reconstruction under arthroscopy,and provide evidence forthe chioce of the graft of ACL reconstruction in clinical.MethodsThe authors systematically searched electronic databases，randomizedcontrolled trials(RCTs),Case-control study and Prospective cohort study werecollected from PubMed，Embase，OVID，CNKI and Wanfang Date，to identifyprospective studies which compared allografts with autografts for primaryACL reconstruction. The results of the eligible studies were analysed in termsof instrumented laxity measurements，Pivot Shift test，Lachman test，objectiveInternational Knee Documentation Committee (IKDC) Scores， LysholmScores and Tegner Scores,by using the Review Manager5.2software.ResultsNine studies met the inclusion criteria,and3in level B,6in level C. TheKT measurements [WMN=-0.12,CI95%(-0.20，-0.03),P=0.008], Pivot Shifttest[RR=1.03， CI95%(0.97,1.10)， P=0.34], Lachman test[RR=1.04，CI95%(0.96,1.14)，P=0.31],IKDC scores [RR=l.00,CI95%(0.79,1.26),P=0.98],lysholm scores [WMN=0.40, CI95%(-0.95，1.75), P=0.56], Tegner scores[WMN=-0.05, CI95%(-0.35，0.25), P=0.74],and There was insufficient evidence to identify which of the two types of grafts was significantly better foranterior cruciate ligament reconstruction.ConclusionsAccording to the researches, there was insufficient evidence to identifywhich of the two types of grafts was significantly better for ACLreconstruction.More high-quality randomized controlled trials with specifiedage and activity level are highly required before drawing a reliable conclusion.