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Arthroskopie

, Volume 32, Issue 6, pp 411–415 | Cite as

Ligamentäre Allografts in der Gelenkchirurgie

  • Gerald GruberEmail author
  • Gerwin A. BernhardtEmail author
Leitthema
  • 14 Downloads

Zusammenfassung

Die Verwendung von Allografts in der Orthopädie und Traumatologie gewinnt immer mehr an Bedeutung. Die eingeschränkte Verfügbarkeit scheint der Vergangenheit anzugehören und stellt immer weniger ein Problem dar, allerdings spielen höhere Kosten gegenüber Autografts eine Rolle. Die meisten validen Studien zur Allograftverwendung stehen in der rekonstruktiven Kniechirurgie zur Verfügung. Insbesondere in Revisionssituationen und bei Multiligamentverletzungen sind Allografts von Vorteil. Eine individuelle Indikationsstellung und Behandlungsstrategie sowie die richtige Patientenselektion scheinen sowohl für Allografts als auch für Autografts die wichtigsten Erfolgsgrößen zu sein. Randomisierte Studien fehlen zumeist und Langzeitergebnisse bleiben noch abzuwarten, um den künftigen Stellenwert von Allografts in der Gelenkchirurgie korrekt abschätzen zu können.

Schlüsselwörter

Spendersehne Transplantation Autograft Rekonstruktion Knie 

Ligament allografts in joint surgery

Abstract

The use of allografts in orthopedics and traumatology is becoming increasingly more important. The limited availability of allografts seems to have become a thing of the past and the problems are becoming less but higher costs compared to autografts play a role. Most scientific data are available on allograft use in reconstructive knee surgery. Especially in revision situations and in multiligament injuries allografts are an advantageous treatment option. An individual assessment of the indications and treatment strategy and the correct patient selection seem to be the most important success factors for both autografts and allografts. Randomized studies are mostly lacking and long-term results are still to be awaited in order to be able to correctly estimate the significance of allografts in joint surgery in the future.

Keywords

Donor tendon Transplantation Reconstruction Autograft Knee 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

G. Gruber und G.A. Bernhardt geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Literatur

  1. 1.
    Abouljoud MM, Everhart JS, Sigman BO, Flanigan DC, Magnussen RA (2018) Risk of retear following anterior cruciate ligament reconstruction using a hybrid graft of autograft augmented with allograft tissue: a systematic review and meta-analysis. Arthroscopy 34(10):2927–2935PubMedGoogle Scholar
  2. 2.
    Ardern CL, Ekås GR, Grindem H, Moksnes H, Anderson A, Chotel F, Cohen M, Forssblad M, Ganley TJ, Feller JA, Karlsson J, Kocher MS, LaPrade RF, McNamee M, Mandelbaum B, Micheli L, Mohtadi NGH, Reider B, Roe JP, Seil R, Siebold R, Silvers-Granelli HJ, Soligard T, Witvrouw E, Engebretsen L (2018) Prevention, diagnosis and management of paediatric ACL injuries. Br J Sports Med 52(20):1297–1298PubMedGoogle Scholar
  3. 3.
    Arnoczky SP, Warren RF, Ashlock MA (1986) Replacement of the anterior cruciate ligament using a patellar tendon allograft. An experimental study. J Bone Joint Surg Am 68:376–385PubMedGoogle Scholar
  4. 4.
    Asselmeier MA, Caspari RB, Bottenfield S (1993) A review of allograft processing and sterilization techniques and their role in transmission of the human immunodeficiency virus. Am J Sports Med 21(2):170–175PubMedGoogle Scholar
  5. 5.
    Baer GS, Harner CD (2007) Clinical outcomes of allograft versus autograft in anterior cruciate ligament reconstruction. Clin Sports Med 26:661–681PubMedGoogle Scholar
  6. 6.
    Borbas P, Churchill J, Ek ET (2019) Surgical management of chronic high-grade acromioclavicular joint dislocations: a systematic review. J Shoulder Elbow Surg.  https://doi.org/10.1016/j.jse.2019.03.005 CrossRefPubMedGoogle Scholar
  7. 7.
    Borden PS, Nyland JA, Caborn DNM (2001) Posterior cruciate ligament reconstruction (double bundle) using anterior tibialis tendon allograft. Arthroscopy 17(4):E14PubMedGoogle Scholar
  8. 8.
    Chen C, Hunt KJ (2019) Open reconstructive strategies for chronic Achilles tendon ruptures. Foot Ankle Clin 24(3):425–437PubMedGoogle Scholar
  9. 9.
    Cohen SB, Sekiya JK (2007) Allograft safety in anterior cruciate ligament reconstruction. Clin Sports Med 26(4):597–605PubMedGoogle Scholar
  10. 10.
    Condello V, Zdanowicz U, Di Matteo B, Spalding T, Gelber PE, Adravanti P, Heuberer P, Dimmen S, Sonnery-Cottet B, Hulet C, Bonomo M, Kon E (2019) Allograft tendons are a safe and effective option for revision ACL reconstruction: a clinical review. Knee Surg Sports Traumatol Arthrosc 27(6):1771–1781PubMedGoogle Scholar
  11. 11.
    Curtis RJ, Delee JC, Drez DJ Jr (1985) Reconstruction of the anterior cruciate ligament with freeze dried fascia lata allografts in dogs: a preliminary report. Am J Sports Med 13:408–414PubMedGoogle Scholar
  12. 12.
    Diniz P, Pacheco J, Flora M, Quintero D, Stufkens S, Kerkhoffs G, Batista J, Karlsson J, Pereira H (2019) Clinical applications of allografts in foot and ankle surgery. Knee Surg Sports Traumatol Arthrosc 27(6):1847–1872PubMedGoogle Scholar
  13. 13.
    Gallie WE (1921) The implantation of tendons. Ann Surg 35:268Google Scholar
  14. 14.
    Goddard M, Bowman N, Salmon LJ, Waller A, Roe JP, Pinczewski LA (2013) Endoscopic anterior cruciate ligament reconstruction in children using living donor hamstring tendon allografts. Am J Sports Med 41(3):567–574PubMedGoogle Scholar
  15. 15.
    Grassi A, Carulli C, Innocenti M, Mosca M, Zaffagnini S, Bait C, SIGASCOT Arthroscopy Committee (2018) Trends in anterior cruciate ligament reconstruction: a systematic review of national surveys of the last 5 years. Joints 6(3):177–187PubMedPubMedCentralGoogle Scholar
  16. 16.
    Grassi A, Nitri M, Moulton SG, Marcheggiani Muccioli GM, Bondi A, Romagnoli M, Zaffagnini S (2017) Does the type of graft affect the outcome of revision anterior cruciate ligament reconstruction? A meta-analysis of 32 studies. Bone Joint J 99-B(6):714–723PubMedGoogle Scholar
  17. 17.
    Greaves LL, Hecker AT, Brown CH Jr (2008) The effect of donor age and low-dose gamma irradiation on the initial biomechanical properties of human tibialis tendon allografts. Am J Sports Med 36(7):1358–1366PubMedGoogle Scholar
  18. 18.
    Hulet C, Sonnery-Cottet B, Stevenson C, Samuelsson K, Laver L, Zdanowicz U, Stufkens S, Curado J, Verdonk P, Spalding T (2019) The use of allograft tendons in primary ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 27(6):1754–1770PubMedGoogle Scholar
  19. 19.
    Jackson DW, Grood ES, Goldstein JD, Rosen MA (1993) A comparison of patellar tendon autograft and allograftused for anterior cruciate ligament reconstruction in the goatmodel. Am J Sports Med 21:176PubMedGoogle Scholar
  20. 20.
    Jackson DW, Corsetti J, Simon TM (1996) Biologic incorporation of allograft anterior cruciate ligament replacements. Clin Orthop 324:126–133Google Scholar
  21. 21.
    Kane PW, Wascher J, Dodson CC, Hammoud S, Cohen SB, Ciccotti MG (2016) Anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft versus allograft in skeletally maturen patients aged 25 years or younger. Knee Surg Sports Traumatol Arthrosc 24:3627–3633PubMedGoogle Scholar
  22. 22.
    Kang L, Patel Y (2019) Technique of tendon interposition arthroplasty for chronic volar dislocation of the distal radioulnar joint. J Hand Surg Am 44(7):621.e1–621.e7Google Scholar
  23. 23.
    Kernwein G, Fahey J, Garrison M (1938) The fate of tendon, fascia and elastic connective tissue transplanted into bone. Ann Surg 108(2):285–290PubMedPubMedCentralGoogle Scholar
  24. 24.
    Kraeutler MJ, Bravman JT, McCarty EC (2013) Bone-patellar tendon-bone autograft versus allograft in outcomes of anterior cruciate ligament reconstruction: a meta-analysis of 5182 patients. Am J Sports Med 41(10):2439–2448PubMedGoogle Scholar
  25. 25.
    Kumar N, Bastrom TP, Dennis MM, Pennock AT, Edmonds EW (2018) Adolescent medial patellofemoral ligament reconstruction: a comparison of the use of autograft versus allograft hamstring. Orthop J Sports Med 6(5):2325967118774272PubMedPubMedCentralGoogle Scholar
  26. 26.
    Lewington MR, Ferguson DP, Smith TD, Burks R, Coady C, Wong ICH (2017) Graft utilization in the bridging reconstruction of irreparable rotator cuff tears: a systematic review. Am J Sports Med 45(13):3149–3157PubMedGoogle Scholar
  27. 27.
    Li J, Li Y, Wei J, Wang J, Gao S, Shen Y (2014) A simple technique for reconstruction of medial patellofemoral ligament with bone-fascia tunnel fixation at the medial margin of the patella: a 6‑year-minimum follow-up study. J Orthop Surg Res 9:66PubMedPubMedCentralGoogle Scholar
  28. 28.
    Macewen W (1881) Observations concerning transplantation of bone. Proc R Soc Lond 32:232–247Google Scholar
  29. 29.
    McNeilan RJ, Everhart JS, Mescher PK et al (2018) Graft choice in isolated medial patellofemoral ligament reconstruction: a systematic review with meta-analysis of rates of recurrent instability and patient-reported outcomes for autograft, allograft, and synthetic options. Arthroscopy 34(4):1340–1354PubMedGoogle Scholar
  30. 30.
    Mistry H, Metcalfe A, Colquitt J, Loveman E, Smith NA, Royle P, Waugh N (2019) Autograft or allograft for reconstruction of anterior cruciate ligament: a health economics perspective. Knee Surg Sports Traumatol Arthrosc 27(6):1782–1790PubMedPubMedCentralGoogle Scholar
  31. 31.
    Molenaars RJ, Schoolmeesters BJA, Viveen J, The B, Eygendaal D (2019) There is a role for allografts in reconstructive surgery of the elbow and forearm. Knee Surg Sports Traumatol Arthrosc 27:1840–1846PubMedGoogle Scholar
  32. 32.
    Nagda SH, Altobelli GG, Bowdry KA, Brewster CE, Lombardo SJ (2010) Cost analysis of outpatient anterior cruciate ligament reconstruction: autograft versus allograft. Clin Orthop Relat Res 468(5):1418–1422PubMedGoogle Scholar
  33. 33.
    Peacock EE Jr (1959) Some problems in flexor tendon healing. Surgery 45:415PubMedGoogle Scholar
  34. 34.
    Peacock EE Jr, Madden JW (1967) Human composite flexor tendon allografts. Ann Surg 166(4):624–629PubMedPubMedCentralGoogle Scholar
  35. 35.
    Rihn JA, Harner CD (2003) The use of musculoskeletal allograft tissue in knee surgery. Arthroscopy 19(Suppl 1):51–66PubMedGoogle Scholar
  36. 36.
    Shino K, Inoue M, Horibe S (1991) Surface blood flow and histology of human anterior cruciate ligament allografts. Arthroscopy 7:171–176PubMedGoogle Scholar
  37. 37.
    Sochacki KR, McCulloch PC, Lintner DM, Harris JD (2019) Hamstring autograft versus hybrid graft in anterior cruciate ligament reconstruction: a systematic review of comparative studies. Arthroscopy 35(6):1905–1913PubMedGoogle Scholar
  38. 38.
    Strauss MJ, Varatojo R, Boutefnouchet T, Condello V, Samuelsson K, Gelber PE, Adravanti P, Laver L, Dimmen S, Eriksson K, Verdonk P, Spalding T (2019) The use of allograft tissue in posterior cruciate, collateral and multi-ligament knee reconstruction. Knee Surg Sports Traumatol Arthrosc 27(6):1791–1809PubMedGoogle Scholar
  39. 39.
    Tian P, Hu WQ, Li ZJ, Sun XL, Ma XL (2017) Comparison of autograft and allograft tendons in posterior cruciate ligament reconstruction: a meta-analysis. Medicine (Baltimore) 96(27):e7434Google Scholar
  40. 40.
    Tom JA, Rodeo SA (2002) Soft tissue allografts for knee reconstruction in sports medicine. Clin Orthop 402:135–156Google Scholar
  41. 41.
    Wang CJ, Chan YS, Wenig LH, Yuan LJ, Chen HS (2004) Comparison of autogenous and allogenous posterior cruciate ligament reconstructions of the knee. Injury 35:1279–1285PubMedGoogle Scholar
  42. 42.
    Wang S, Zhang C, Cai Y, Lin X (2018) Autograft or allograft? Irradiated or not? A contrast between autograft and allograft in anterior cruciate ligament reconstruction: a meta-analysis. Arthroscopy 34(12):3258–3265PubMedGoogle Scholar
  43. 43.
    Waugh N, Mistry H, Metcalfe A, Colquitt J, Loveman E, Royle P, Smith NA (2019) Allografts in reconstruction of the posterior cruciate ligament: a health economics perspective. Knee Surg Sports Traumatol Arthrosc 27(6):1810–1816PubMedPubMedCentralGoogle Scholar
  44. 44.
    Wei J, Yang HB, Qin JB, Yang TB (2015) A meta-analysis of anterior cruciate ligament reconstruction with autograft compared with nonirradiated allograft. Knee 22(5):372–379PubMedGoogle Scholar
  45. 45.
    Weinberger JM, Fabricant PD, Taylor SA et al (2017) Influence of graft source and configuration on revision rate and patient-reported outcomes after MPFL reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 25(8):2511–2519PubMedGoogle Scholar
  46. 46.
    Zeng C, Gao SG, Li H, Yang T, Luo W, Li YS, Lei GH (2016) Autograft versus allograft in anterior cruciate ligament reconstruction: a meta-analysis of randomized controlled trials and systematic review of overlapping systematic reviews. Arthroscopy 32(1):153–163PubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Univ. Klinik für Orthopädie und TraumatologieMedizinische Universität GrazGrazÖsterreich

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