Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction

Abstract

Background: The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to compare the clinical outcomes of autograft versus allograft tendons in patients who underwent posterior cruciate ligament (PCL) reconstruction. Methods: We conducted a search of PubMed, EMBASE, The Cochrane Library, and Web of Science databases for RCTs and non-RCTs comparing autograft and allograft tendons in PCL reconstruction up to August 2016. The outcomes were Lysholm knee function score, postoperative objective and subjective International Knee Documentation Committee Score (IKDCS), Tegner activity scale, and knee posterior stability. Data analysis was performed using RevMan 5.3 software. Results: One RCT and 4 non-RCTs met the inclusion criteria. The current meta-analysis indicated that there were no significant differences in the Lysholm knee function score (mean difference [MD] =-0.99, 95% confidence interval [CI]:-5.51 to 3.54, P = .67), Tegner activity scale (MD = 0.46, 95% CI: 0.03 to 0.90, P = .04), postoperative objective IKDCS (odds ratio [OR] = 1.66, 95% CI: 0.77 to 3.58, P = .20), postoperative subjective IKDCS (MD = 3.00, 95% CI:-0.29 to 6.29, P = .07), or knee posterior stability (MD =-0.45, 95% CI:-1.28 to 0.38, P = .29) between patients who received autograft tendons and those who received allograft tendons. The patients with autograft tendons had a higher Tegner activity scale (MD = 0.46, 95% CI: 0.03 to 0.90, P = .04) than those with allograft tendons. Conclusions: The present meta-analysis shows that there was insufficient evidence to indicate that allograft tendons were significantly better than autograft tendons for PCL reconstruction. Due to the limited quality and data in the studies currently available, in the future, more high-quality RCTs are required to answer this question more definitively.