Official Journal of the Italian Society of Orthopaedics and Traumatology
Table 1 Key questions, selected studies and recommendations on use of autograft in arthroscopic ACL reconstruction
From: Graft selection in arthroscopic anterior cruciate ligament reconstruction
Key questions | Studies | Recommendations |
|---|---|---|
Is use of autograft effective in patients with anterior cruciate ligament injury (with or without meniscal lesions and/or grade I/II focal chondral lesions) and a shared indication to arthroscopic reconstruction? | 407 identified, 26 selected, 19 rated, 19 included | Clinical practice Evidence is currently not sufficient to absolutely recommend use of one of the treated autograft techniques. Higher stability subsequent to use of patellar tendon is proven, while use of hamstring is suggested in patients needing, for various reasons, to stay on their knees for long periods of time, and who therefore need a substantial reduction of intensity and length of pain |
Is use of autograft safe in patients with anterior cruciate ligament injury (with or without meniscal lesions and/or grade I/II focal chondral lesions) and a shared indication to arthroscopic reconstruction? | 48 identified, 5 selected, 5 rated, 5 included | Research The methodological quality of the studies investigating the different autograft techniques is not very high. Randomized studies are therefore needed, with good statistical power, adequate blinding procedures in the choice of outcomes and a standardized definition of interventions and outcomes Qualitative studies are also needed, aimed at investigating patients’ (and clinicians’) preferences in relation to the relevance of the considered outcomes Further studies are finally recommended, aimed at testing the effectiveness of autograft with hamstring associated to extra-articular surgery to contain laxity |