Autografts promote post-operative activity level compared to allografts in posterior cruciate ligament reconstruction: a systematic review and meta-analysis

Objective: To compare the clinical outcomes of autografts with allografts in PCL reconstruction. Methods: Data bases including Pubmed, Cochrane Library databases, Web of Science, and Grey literature were searched from their inception to January, 2017. Literature search, quality assessment, and data extraction were independently conducted by two investigators. The data were analyzed by using the Cochrane Collaboration Review Manager software (RevMan, version 5.3). The primary outcomes were overall IKDC levels and subjective IKDC scores. The secondary outcomes included Lysholm scores, TAS, instrumented knee laxity test and complications. Results: A total of 5 studies containing 130 patients in autograft groups and 122 patients in allograft groups were included. Study quality was evaluated by using the Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta-analyses. The results of meta-analysis revealed that autografts can significantly promote the level of TAS (MD: 0.46, [95% CI: 0.03 to 0.90]; P=0.04) compared to allografts for patients after PCL reconstruction. As for complication aspect, paresthesias or pains at donor-site or incision were higher frequency of occurrence in autograft groups compared with allograft groups (OR: 4.46 [95% CI: 1.81 to 10.96]; P=0.001). There was no significant difference between autografts and allografts with respect to overall IKDC levels, subjective IKDC scores, Lysholm scores, and instrumented knee laxity test. Conclusions: Autografts can provide a higher level of postoperative activity than allografts for patients after PCL reconstruction. The finding is limited by the quantity of included literatures and the lack of randomized controlled trials.