Martin Eigenschink1, Philipp R Heuberer2,3, Leo Pauzenberger1, Grant E Garrigues4, Leonard Achenbach5, Sigbjorn Dimmen6, Brenda Laky1, Lior Laver7. 1. AURROM, Austrian Research Group for Regenerative and Orthopedic Medicine, Vienna, Austria. 2. Health Pi, Wollzeile 1-3, 1010, Vienna, Austria. philipp@heuberer.at. 3. AURROM, Austrian Research Group for Regenerative and Orthopedic Medicine, Vienna, Austria. philipp@heuberer.at. 4. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA. 5. Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany. 6. Lovisenberg Diaconal Hospital, Oslo, Norway. 7. The Royal Orthopaedic Hospital - NHS foundation trust, Birmingham, UK.
Abstract
PURPOSE: The aim of this review was to compare clinical and radiological outcome of acromio-clavicular joint reconstruction with allografts versus autografts. METHODS: The PubMed, MEDLINE, The Cochrane Library and WEB OF SCIENCE databases were searched in accordance with the PRISMA guidelines until February 2020 using the terms: 'coracoclavicular' OR 'coraco-clavicular' OR 'acromioclavicular' OR 'acromio-clavicular joint', AND 'reconstruction'. All studies reporting on clinical and radiological outcome as well as complications after ACJ reconstruction using allo- and/or autografts were included. RESULTS: A total of 29 articles, including 2 prospective and 27 retrospective studies, involving 622 patients, reconstructed with either allo- (n = 360) or auto-grafts (n = 262), for acromio-clavicular joint instability were identified and included in this review. The majority of studies had low sample sizes (66.7% below n = 20), were retrospective (93.3%), with short-term follow-ups (average 26.2 ± 12.6 months; range 6-186). The study with the largest sample size (n = 128) did not report clinical outcome. A comparison between allo- and auto-graft showed no significant differences regarding age, gender, and follow-up times. Clinical outcome was comparable in both groups, loss of reduction (LOR) and complication rates were higher in the allograft group. Overall a reduction of LOR was shown if additional horizontal stabilization was performed. Also a higher LOR and revision rate was documented in allografts without suture or suture-tape augmentation. The use of more clavicular drill-holes correlated with a higher frequency of fracture. CONCLUSIONS: A systematic review of the available peer-reviewed literature addressing allograft and autograft reconstruction of unstable coracoclavicular ligaments shows that the published studies are generally of low quality with low levels of evidence. The published literature shows no significant difference in clinical outcomes between the use of autografts or allografts in ACJ reconstruction surgery. Surgical techniques utilizing additional horizontal stabilization may contribute to lower rates of LOR. In cases where allograft tissue is used for ACJ reconstruction the use of suture/tape augmentation may reduce LOR rates as well as revision rates. LEVEL OF EVIDENCE: III.
PURPOSE: The aim of this review was to compare clinical and radiological outcome of acromio-clavicular joint reconstruction with allografts versus autografts. METHODS: The PubMed, MEDLINE, The Cochrane Library and WEB OF SCIENCE databases were searched in accordance with the PRISMA guidelines until February 2020 using the terms: 'coracoclavicular' OR 'coraco-clavicular' OR 'acromioclavicular' OR 'acromio-clavicular joint', AND 'reconstruction'. All studies reporting on clinical and radiological outcome as well as complications after ACJ reconstruction using allo- and/or autografts were included. RESULTS: A total of 29 articles, including 2 prospective and 27 retrospective studies, involving 622 patients, reconstructed with either allo- (n = 360) or auto-grafts (n = 262), for acromio-clavicular joint instability were identified and included in this review. The majority of studies had low sample sizes (66.7% below n = 20), were retrospective (93.3%), with short-term follow-ups (average 26.2 ± 12.6 months; range 6-186). The study with the largest sample size (n = 128) did not report clinical outcome. A comparison between allo- and auto-graft showed no significant differences regarding age, gender, and follow-up times. Clinical outcome was comparable in both groups, loss of reduction (LOR) and complication rates were higher in the allograft group. Overall a reduction of LOR was shown if additional horizontal stabilization was performed. Also a higher LOR and revision rate was documented in allografts without suture or suture-tape augmentation. The use of more clavicular drill-holes correlated with a higher frequency of fracture. CONCLUSIONS: A systematic review of the available peer-reviewed literature addressing allograft and autograft reconstruction of unstable coracoclavicular ligaments shows that the published studies are generally of low quality with low levels of evidence. The published literature shows no significant difference in clinical outcomes between the use of autografts or allografts in ACJ reconstruction surgery. Surgical techniques utilizing additional horizontal stabilization may contribute to lower rates of LOR. In cases where allograft tissue is used for ACJ reconstruction the use of suture/tape augmentation may reduce LOR rates as well as revision rates. LEVEL OF EVIDENCE: III.
Authors: Patrick A Dawson; Gregory J Adamson; Marilyn M Pink; Matthew Kornswiet; Steven Lin; James A Shankwiler; Thay Q Lee Journal: J Shoulder Elbow Surg Date: 2008-12-25 Impact factor: 3.019
Authors: Bryan P Conrad; Matthew Rappé; MaryBeth Horodyski; Kevin W Farmer; Peter A Indelicato Journal: Cell Tissue Bank Date: 2012-09-13 Impact factor: 1.522
Authors: Jay B Cook; James S Shaha; Douglas J Rowles; Craig R Bottoni; Steven H Shaha; John M Tokish Journal: Am J Sports Med Date: 2012-11-08 Impact factor: 6.202
Authors: Knut Beitzel; Elifho Obopilwe; John Apostolakos; Mark P Cote; Ryan P Russell; Ryan Charette; Hardeep Singh; Robert A Arciero; Andreas B Imhoff; Augustus D Mazzocca Journal: Am J Sports Med Date: 2014-07-02 Impact factor: 6.202
Authors: Jay B Cook; James S Shaha; Douglas J Rowles; Craig R Bottoni; Steven H Shaha; John M Tokish Journal: J Shoulder Elbow Surg Date: 2012-04-21 Impact factor: 3.019
Authors: Knut Beitzel; Mark P Cote; John Apostolakos; Olga Solovyova; Christopher H Judson; Connor G Ziegler; Cory M Edgar; Andreas B Imhoff; Robert A Arciero; Augustus D Mazzocca Journal: Arthroscopy Date: 2013-02 Impact factor: 4.772
Authors: Ryan W Paul; Zachary S Aman; Bryson R Kemler; Alim Osman; James P Doran; Joseph Brutico; Fotios P Tjoumakaris; Kevin B Freedman Journal: Arthrosc Sports Med Rehabil Date: 2022-07-07