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Comparison of human tendon allografts and autografts used in knee reconstruction

01/11/2011

Klimkiewicz, John J.a; Samsell, Brian J.b; Riff, Andrewa; DeBerardino, Thomas M.c; Moore, Mark A.b

Georgetown University Hospital, Washington, DC
LifeNet Health, Virginia Beach, VA
c University of Connecticut Health Center, Farmington, CT
Financial Disclosures: Dr. DeBerardino is a paid consultant for Arthrex, has received institutional support and grants from Arthrex as well as support for lectureships, and has received support for lectureships from MTF and Genzyme Biosurgery. Brian J. Samsell was employed in the past by LifeNet Health; Mark A. Moore currently is an employee of LifeNet Health.
The authors declare no confliets ofinterest.
Correspondence to Mark A. Moore, PhD, LifeNet Health, 1864 Concert Drive, Virginia Beach, VA 23453
Tel: + 1 757 609 4409; fax: + 1 757 464 5721;
e-niail: mark_moore@lifenethealth.org.
1940-7041 © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Abstract

Despite the long-term experience with the use of both human tendon allografts and autografts in anterior cruciate ligament (ACL) reconstruction procedures, there remains no clear consensus on overall graft preference. While bone-patellar tendon-bone (BPTB) autografts were once considered the gold standard, modern advances and availability have made the allograft option more appealing to surgeons and patients alike. With the number of ACL reconstructions increasing every year, it is important for surgeons to have current knowledge about the advantages and disadvantages for each graft source. This paper will compare the effectiveness of allografts and autografts in ACL reconstruction procedures with regard to postoperative outcomes and complications, biologic incorporation and laxity, athletic rehabilitation, athletic participation, functional limitations, pain, and cost.

 

Conclusion

As reviewed here, there is much data regarding the choice to use either allograft or autograft tendons for ACL reconstruc-tion. There are numerous clinical studies reporting similar results for the two procedures.2'5'34 While allografts do carry a legitímate risk of disease transmission, modern methods for cleaning and terminal sterilization used by most tissue banks negate this concern. An advantage towards allograft tissue is a decrease in the donor site morbidity often associated with autograft tissue. While the "gold standard" designation given to the BPTB autograft is a commonly stated advantage by some literature sources,3 more surgeons using allografts are reporting equivalent results to auto-grafts. As surgeons gain confidence with these reports and the results of their own patients, allografts have become an acceptable and even desirable option to autograft tissue for ACL reconstruction procedures.

Current Orthopaedic Practice:
November/December 2011 - Volume 22 - Issue 6 - p 494–502
doi: 10.1097/BCO.0b013e318236c466
SPECIAL FOCUS: Sports Medicine

Traducción al español

Conclusión

Como ya han dicho aquí, hay muchos datos en relación con la opción de utilizar cualquiera de aloinjerto o autoinjerto tendones para reconstrucción ACL. Existen numerosos estudios clínicos que informaron resultados similares para los dos procedimientos.2'5'34 Mientras aloinjertos no conllevan un riesgo legítimo de transmisión de la enfermedad, los métodos modernos para la limpieza y esterilización terminal utilizado por la mayoría de los bancos de tejidos niegan esta preocupación. Una ventaja hacia el tejido de aloinjerto es una disminución en la morbilidad del sitio donante a menudo asociada con el tejido de autoinjerto. Si bien la designación "estándar de oro", otorgado a la autoinjerto HTH es una ventaja comúnmente señalado por algunas fuentes bibliográficas, 3 más cirujanos que utilizan aloinjertos están reportando resultados equivalentes a auto-injertos. Como cirujanos ganan confianza con estos informes y los resultados de sus propios pacientes, los aloinjertos se han convertido en una opción aceptable e incluso deseable autoinjerto de tejido para los procedimientos de reconstrucción del LCA.




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