Effect of graft types for outcomes in revision anterior cruciate ligament reconstruction: A meta-analysis

Abstract

Purpose: This meta-analysis was performed to compare outcomes among different types of graft for revision anterior cruciate ligament reconstruction (ACLR).

Methods: A comprehensive search from Embase, PubMed, and Cochrane Library was performed to identify relevant articles. Studies that conducted a comparative analysis on outcomes among different types of grafts were included. A meta-analysis was performed using Review Manager 5.4 software.

Results: In total, 7 non-randomized studies with a minimum 1-year follow-up were included in analysis, and all studies compared outcomes between autograft and allograft. International Knee Documentation Committee subjective knee (IKDC) scores and side-to-side anterior laxity were not significantly different between autograft and allograft. Revision ACLR with allograft had a higher risk of failure than autograft at the final follow-up (OR=2.22, 95% CI=1.55-3.18). The rates of return to pre-injury type of sport and return to same and higher level of pre-injury sport were not significantly different between autograft and allograft.

Conclusion: The outcomes of IKDC score, side-to-side anterior laxity, and rates of return to sport were not significantly different between autograft and allograft. Autografts provide a significantly lower risk of failure than allografts in revision ACLR.

Level of evidence: IV; meta-analysis.

Keywords: Allograft; Autograft; Clinical outcomes; Failure; Return to sport; Revision anterior cruciate ligament reconstruction.