Document Detail


Does autograft choice determine intermediate-term outcome of ACL reconstruction?
MedLine Citation:
PMID:  20953764     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Many clinical studies and systematic reviews have compared the short-term (2 years) outcomes of ACL reconstruction with hamstring and patellar tendon autograft. Few differences have been observed, with the exception of increased kneeling pain with patellar tendon grafts. The goal of this systematic review is to determine whether there are differences in clinical, patient-reported, or radiographic outcomes based on graft choice at a minimum of 5 years after ACL reconstruction.
METHODS: A systematic review was performed to identify all prospective outcome studies comparing patellar tendon and hamstring autograft ACL reconstruction with minimum follow-up of at least 5 years. Seven studies were identified and meta-analysis of select data determined to be sufficiently homogenous was performed (failure and laxity).
RESULTS: Five randomized controlled trials and two prospective cohorts comparing hamstring and patellar tendon autografts were identified. Clinical assessment [failure rate, International Knee Documentation Committee (IKDC) class, Lachman, pivot shift, and KT 1000 testing] showed no difference between grafts. Patient-reported outcomes (Lysholm, Cincinnati, and IKDC) showed no difference. Both anterior knee pain (3/3 studies) and kneeling pain (4/4 studies) were more frequent in the patellar tendon group. However, the patient-reported outcomes in these studies were not different. Radiographic evidence of osteoarthritis was inconsistent between autograft choices.
CONCLUSION: This level II systematic review demonstrates no difference in major clinical results between graft types with the exception of increased anterior knee and kneeling pain. There exists a potential for increased incidence of osteoarthritis in the patellar tendon group but increased sample size is required. These longer-term outcomes are similar to results of prior systematic reviews with two-year follow-up.
Authors:
Robert A Magnussen; James L Carey; Kurt P Spindler
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Publication Detail:
Type:  Comparative Study; Journal Article; Review     Date:  2010-10-15
Journal Detail:
Title:  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA     Volume:  19     ISSN:  1433-7347     ISO Abbreviation:  Knee Surg Sports Traumatol Arthrosc     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-14     Completed Date:  2011-06-24     Revised Date:  2013-08-22    
Medline Journal Info:
Nlm Unique ID:  9314730     Medline TA:  Knee Surg Sports Traumatol Arthrosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  462-72     Citation Subset:  IM    
Affiliation:
Duke Sports Medicine, 280 Frank Bassett Dr., Durham, NC 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Anterior Cruciate Ligament / injuries,  surgery*
Arthroscopy / adverse effects,  methods
Female
Graft Rejection
Graft Survival
Humans
Joint Instability / prevention & control
Knee Injuries / surgery
Male
Pain Measurement
Patellar Ligament / transplantation*
Patient Satisfaction
Range of Motion, Articular / physiology*
Reconstructive Surgical Procedures / adverse effects,  methods*
Recovery of Function
Risk Assessment
Tendon Transfer / methods
Tendons / transplantation*
Transplantation, Autologous
Grant Support
ID/Acronym/Agency:
R01 AR053684/AR/NIAMS NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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