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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(03): 388-396
DOI: 10.1055/s-0043-1768618
Revisão sistemática e Metanálise
Quadril

Graft Selection Between Tendon Autograft and Allograft in Anterior Cruciate Ligament Reconstruction Based on the Histological Perspective: A Meta-Analysis

Article in several languages: português | English
Celleen Rei Setiawan 
1   Departamento de Ortopedia e Traumatologia, Sanglah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonésia.
,
I Gusti Ngurah Wien Aryana
1   Departamento de Ortopedia e Traumatologia, Sanglah General Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonésia.
› Author Affiliations Financial Support The authors declare that they have not received any no financial support from public, commercial, or non-profit sources to conduct the present study.
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Abstract

Objective: The purpose of this meta-analysis is to compare ligament healing on autograft and allograft in anterior cruciate ligament (ACL) reconstruction.

Methods: The selection of appropriate studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We made a statistical analysis using a review manager. Electronic reports were searched using the PubMed, Medline, and Cochrane Library databases. The inclusion criteria were animal studies and cellular histology of both grafts as an outcome.

Results: The initial search revealed 412 potential articles. After duplicates were removed, 246 articles remained. Then, 14 articles were obtained and screened for relevance and eligibility. The relevant articles were searched manually, checking for eligibility and details in order not to miss included reports. Subsequently, 5 studies were included, with a total of 232 samples, reporting the biopsied results with quantitative histology of ligament healing between allograft and autograft. The biopsy samples in those studies were examined under light or electron microscope, to analyze the cellular distribution area and ligamentization stages in each group. Meta-analyses found significant difference between autograft and allograft (Heterogeneity, I2 = 89%; Mean Difference, 95% confidence interval [CI] = −34.92, −54.90, −14.93; p = 0.0006). There is also a significant difference on both graft in cellular count at over 24 weeks (Heterogeneity, I2 = 26%; Mean Difference, 95% CI = −14.59, −16.24, −12.94; p < 0.00001).

Conclusion: In the current meta-analysis, autograft shows a significant difference when compared to allograft, with more cellular accumulation and faster remodeling response on the ligamentization process being noticed in the former. However, a larger clinical trial will be needed to emphasize this literature's result.

Keywords

Adolescent - Allograft - Anterior cruciate ligament reconstruction - Autograft

Work developed in the Department of Orthopedics and Traumatology, Sanglah General Hospital, Faculty of Medicine Udayana University, Denpasar, Bali, Indonesia.




Publication History

Received: 04 July 2022

Accepted: 04 October 2022

Article published online:
29 June 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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