Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Laura Levy, DHSc, PA-C
OBJECTIVE: The objective of the selective EBM review is to determine whether or not, “Is the use of fresh-frozen allograft more effective than a hamstring autograft in preserving functional knee ability post-surgery in ACL reconstruction?”
STUDY DESIGN: Review of two randomized control trials (RCTs) and one prospective randomized study published between 2011 and 2016, all in English language. The articles compared allograft tendon versus autograft tendon when undergoing ACL reconstructive surgery.
DATA SOURCES: Two randomized control trials (RCTs) and one prospective randomized study were found using PubMed, NCBI, and Cochrane databases. All articles were published in reviewed journals and selected based on correlation to topic choice, date of publication, and evaluation of POEMs.
OUTCOMES MEASURED: Subjective IKDC (International Knee Documentation Committee) Functional Knee Evaluation scoring system was used. It is a subjective scale questionnaire that produces an overall function score by assessing 3 categories: symptoms, sports activity, and knee function.
RESULTS: All three studies found no statistically significant difference in post-ACLR functioning and activity level when considering the Subjective IKDC scores for allograft versus autograft tendons. The study by Sun et al. showed no significant differences between the irradiated, fresh-frozen hamstring allograft and hamstring autograft groups (p=0.208) according to the subjective IKDC scores. Tian et al. concluded that patients receiving the fresh-frozen hamstring allograft showed no significant difference in subjective IKDC scores compared to the hamstring tendon autograft group (p=0.633). Lawhorn et al. also found no statistical differences between the mean IKDC subjective scores of the fresh-frozen anterior tibialis allograft group and the hamstring autograft group (p>0.05).
CONCLUSION: All three studies found no statistically significant differences in the subjective measures of knee stability and function when using an allograft versus an autograft tendon; however, further research is warranted as the studies noted limitations of their methods, and some acknowledged functional differences between the graft types when considering non-POEM results.
Black, Carly E., "Is the Use of a Fresh-frozen Allograft More Effective than a Hamstring Autograft in Preserving Functional Knee Ability Post-surgery in ACL Reconstruction?" (2019). PCOM Physician Assistant Studies Student Scholarship. 456.