Comparison of The Clinical Results of Anterior Cruciate Ligament Reconstruction with Autologous Versus Allogeneic Grafts: A Meta- Analysis
Abstract
Objective: To compare the clinical results of anterior cruciate ligament (ACL) reconstruction using autologous versus allogeneic grafts, by means of a systematic review with meta-analysis. Methodology: The review was conducted according to the PRISMA guidelines, with searches in PubMed/MEDLINE, Embase, Cochrane Library and Scopus. Randomized clinical trials published between 2011 and 2025 involving adult patients undergoing primary ACL reconstruction were included. The outcomes assessed were function (subjective and objective IKDC, Lysholm, Tegner, Cincinnati), joint stability (clinical tests and arthrometer) and complications, including graft failure. Methodological quality was assessed using the Cochrane Risk of Bias tool. Results: After initial screening of 14 articles, 5 studies met the inclusion criteria, totaling 471 patients (238 autogenous and 233 allogenous). Both groups showed significant improvement in joint function and stability at follow-up ≥ 24 months, with no statistically significant differences in functional scores. However, the failure rate was higher in allografts (up to 26% in some studies). Conclusion: ACL reconstruction with autografts and allografts results in significant clinical improvement, but autografts have a lower risk of failure and greater stability, making them the preferred option in high-demand individuals.
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