Dataset Information

Allografts in reconstruction of the posterior cruciate ligament: a health economics perspective.

ABSTRACT:

Purpose

To review the relative cost-effectiveness of allografts and autografts in reconstruction of the posterior cruciate ligament.

Methods

Systematic review and cost-effectiveness analysis.

Results

The available evidence does not show any significant difference in clinical effectiveness between autografts and allografts. Given that, only a cost analysis is provided, which shows that allografts are more costly.

Conclusion

Given the lack of any benefit of allografts over autografts, autografts should be preferred on cost grounds, if available. However, there may be situations where an allograft is indicated, for example, in multiple ligament reconstructions.

Level of evidence

IV.

SUBMITTER: Waugh N

PROVIDER: S-EPMC6541577 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

Allografts in reconstruction of the posterior cruciate ligament: a health economics perspective.

Waugh Norman N Mistry Hema H Metcalfe Andrew A Colquitt Jill J Loveman Emma E Royle Pamela P Smith Nick A NA

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 20190322 6

<h4>Purpose</h4>To review the relative cost-effectiveness of allografts and autografts in reconstruction of the posterior cruciate ligament.<h4>Methods</h4>Systematic review and cost-effectiveness analysis.<h4>Results</h4>The available evidence does not show any significant difference in clinical effectiveness between autografts and allografts. Given that, only a cost analysis is provided, which shows that allografts are more costly.<h4>Conclusion</h4>Given the lack of any benefit of allografts ...[more]

PMID: 30903218

Similar Datasets

Project description:PurposeTo evaluate the evidence of the effectiveness and safety of allografts compared to autografts in posterior cruciate ligament reconstruction.MethodsFour electronic databases were systematically searched for eligible randomized controlled studies. Crucial effectiveness outcomes included patient-reported function, activity level and symptoms, clinical knee stability, health-related quality of life, and patient satisfaction. Safety was evaluated through graft failures, revisions, reruptures and complications. The internal validity of the studies was assessed by the Cochrane risk of bias tool, and the strength of the evidence was judged according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).ResultsTwo randomized controlled studies were included: 50 patients were analyzed in the allograft group and 58 in the autograft group. No statistically significant postoperative differences were reported between the groups for patient-reported function, activity levels or symptoms. One study reported a statistically significant difference in instrumented postoperative anteroposterior knee laxity favoring stability in autografts. This difference is, however, not relevant in the clinical setting. Insufficient evidence was found to judge safety outcomes and because complications were poorly measured, and none of the studies reported on graft failure, revision or rerupture rates. The studies were judged with unclear to high risk of bias. The strength of the evidence for effectiveness and safety was judged to be low to very low, according to GRADE.ConclusionsAllografts may be comparable to autografts for crucial effectiveness outcomes, but insufficient evidence was found to judge crucial safety outcomes due to poor reporting of safety measures and outcomes. Results should be interpreted with caution because there is lack of good-quality evidence to support the superiority of allografts over autografts due to the high risk of bias in the primary studies and overall very low strength of the body of evidence according to GRADE.Level of evidenceSystematic review of Level II studies.

Dataset Information

Allografts in reconstruction of the posterior cruciate ligament: a health economics perspective.

Purpose

Methods

Results

Conclusion

Level of evidence

Publications

Allografts in reconstruction of the posterior cruciate ligament: a health economics perspective.

Similar Datasets

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