A meta-analysis of patellar tendon autograft versus patellar tendon allograft in anterior cruciate ligament reconstruction.
OBJECTIVE
Studies have suggested good long-term success rates with bone-patellar tendon-bone (BPTB) autograft and BPTB allograft in anterior cruciate ligament (ACL) reconstruction, but the numbers reported in available prospective studies may be underpowered to elucidate significant differences between the two groups. Here, we present a meta-analysis to compare the results of BPTB autograft and BPTB allograft in primary ACL reconstruction.


METHODS
A systematic review of prospective trials using BPTB autograft and BPTB allograft tissue for ACL reconstruction with a minimum 2-year follow-up was performed. Summary odds ratios (ORs), confidence intervals, and P values were calculated.


RESULTS
Of 548 studies, 6 fulfilled our inclusion criteria, with 256 patients in the autograft and 278 patients in the allograft group. Allograft patients were more likely to rupture their graft than autograft patients (OR, 5.03; P = .01) and more likely to have a hop test less than 90% of the nonoperative side (OR, 5.66; P < .01). When irradiated and chemically processed grafts were excluded from analysis, no significant differences were found between allograft and autograft patients with respect to graft rupture, rate of reoperation, normal/near normal IKDC scores, Lachman exam, pivot shift exam, patellar crepitus, hop test, or return to sport.


CONCLUSIONS
In this meta-analysis, ACL reconstruction with BPTB autograft was favored over BPTB allograft for graft rupture and hop test parameters. However, when irradiated and chemically processed grafts were excluded, results were not significantly different between the two graft types.


METHODS
Level III, systematic review of prospective nonrandomized cohort studies.
Krych
Aaron J
AJ
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Jackson
Jeffrey D
JD
Hoskin
Tanya L
TL
Dahm
Diane L
DL
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017847:Patellar Ligament / Q000637:transplantation*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous