ACL Reconstruction: Autograft vs Artificial Graft


Research Paper Title

Comparison of artificial graft versus autograft in anterior cruciate ligament reconstruction: a meta-analysis.

Background

Critically evaluation and summarisation for the outcomes between autografts and artificial grafts using in anterior cruciate ligament (ACL) reconstruction have not been performed currently. The purpose of this study is to compare the clinical outcomes between artificial ligaments and autografts at a short- to mid-term follow-up.

Methods

A computerised search of the databases was conducted including Medline, Embase, and the Cochrane library. Only prospective or retrospective comparative studies with a minimum 2-year follow-up and a minimum sample size of 15 for each group were considered for inclusion. Two independent reviewers performed data extraction and methodological quality assessment. A Mantel-Haenszel analysis was used for pooling of results. Sensitivity analysis was performed in order to maintain the stability of results.

Results

Seven studies were included in this study. The total sample size was 403 (autograft group: 206 patients; synthetic graft group: 197 patients). Four studies were randomised controlled trials. Two studies were retrospective comparative studies and one study was non-randomised prospective comparative study. In terms of instrumented laxity, patient-oriented outcomes and complications, no significant difference was occurred between new artificial ligaments and autografts. But the results of IKDC grades and instrumented laxity were worsen in early artificial ligaments compared to autografts.

Conclusions

The outcomes of new generation of artificial ligaments are similar to autografts at a short- to mid-term follow-up. However, the early artificial ligaments are not suggested for ACL reconstruction compared to autografts.

Reference

Jia, Z., Zhang, C., Cao, S., Xue, C., Liu, T. Huang, X. (2017) Comparison of artificial graft versus autograft in anterior cruciate ligament reconstruction: a meta-analysis. BMC Musculoskeletal Disorders. 18: 309. Published online 2017 Jul 19. doi: 10.1186/s12891-017-1672-4.

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