TY - JOUR
T1 - Italian consensus statement for the use of allografts in ACL reconstructive surgery
AU - Bait, Corrado
AU - Randelli, Pietro
AU - Compagnoni, Riccardo
AU - Ferrua, Paolo
AU - Papalia, Rocco
AU - Familiari, Filippo
AU - Tecame, Andrea
AU - Adravanti, Paolo
AU - Adriani, Ezio
AU - Arnaldi, Enrico
AU - Benazzo, Franco
AU - Berruto, Massimo
AU - Bonaspetti, Giovanni
AU - Canata, Gian Luigi
AU - Canè, Pier Paolo
AU - Causero, Araldo
AU - Coari, Giancarlo
AU - Denti, Matteo
AU - Farè, Maristella
AU - Ferretti, Andrea
AU - Fravisini, Marco
AU - Giron, Francesco
AU - Gobbi, Alberto
AU - Madonna, Vincenzo
AU - Manunta, Andrea
AU - Mariani, Pier Paolo
AU - Mazzola, Claudio
AU - Milano, Giuseppe
AU - Pederzini, Luigi
AU - Quaglia, Flavio
AU - Ronga, Mario
AU - Schönhuber, Herbert
AU - Stefani, Giacomo
AU - Volpi, Piero
AU - Zanon, Giacomo
AU - Zini, Raul
AU - Zorzi, Claudio
AU - Zaffagnini, Stefano
PY - 2018/6/2
Y1 - 2018/6/2
N2 - Purpose: Graft choice for primary anterior cruciate ligament reconstruction (ACL-R) is debated, with considerable controversy and variability among surgeons. Autograft tendons are actually the most used grafts for primary surgery; however, allografts have been used in greater frequency for both primary and revision ACL surgery over the past decade. Given the great debate on the use of allografts in ACL-R, the “Allografts for Anterior Cruciate Ligament Reconstruction” consensus statement was developed among orthopedic surgeons and members of SIGASCOT (Società Italiana del Ginocchio, Artroscopia, Sport, Cartilagine, Tecnologie Ortopediche), with extensive experience in ACL-R, to investigate their habits in the use of allograft in different clinical situations. The results of this consensus statement will serve as benchmark information for future research and will help surgeons to facilitate the clinical decision making. Methods: In March 2017, a formal consensus process was developed using a modified Delphi technique method, involving a steering group (9 participants), a rating group (28 participants) and a peer-review group (31 participants). Nine statements were generated and then debated during a SIGASCOT consensus meeting. A manuscript has been then developed to report methodology and results of the consensus process and finally approved by all steering group members. Results: A different level of consensus has been reached among the topics selected. Strong agreement has been reported in considering harvesting, treatment and conservation methods relevant for clinical results, and in considering biological integration longer in allograft compared to autograft. Relative agreement has been reported in using allograft as the first-line graft for revision ACL-R, in considering biological integration a crucial aspect for rehabilitation protocol set-up, and in recommending a delayed return to sport when using allograft. Relative disagreement has been reported in using allograft as the first-line graft for primary ACL-R in patients over 50, and in not considering clinical results of allograft superior to autograft. Strong disagreement has been reported in using allograft as the first-line graft for primary ACL-R and for skeletally immature patients. Conclusions: Results of this consensus do not represent a guideline for surgeons, but could be used as starting point for an international discussion on use of allografts in ACL-R. Level of evidence: IV, consensus of experts.
AB - Purpose: Graft choice for primary anterior cruciate ligament reconstruction (ACL-R) is debated, with considerable controversy and variability among surgeons. Autograft tendons are actually the most used grafts for primary surgery; however, allografts have been used in greater frequency for both primary and revision ACL surgery over the past decade. Given the great debate on the use of allografts in ACL-R, the “Allografts for Anterior Cruciate Ligament Reconstruction” consensus statement was developed among orthopedic surgeons and members of SIGASCOT (Società Italiana del Ginocchio, Artroscopia, Sport, Cartilagine, Tecnologie Ortopediche), with extensive experience in ACL-R, to investigate their habits in the use of allograft in different clinical situations. The results of this consensus statement will serve as benchmark information for future research and will help surgeons to facilitate the clinical decision making. Methods: In March 2017, a formal consensus process was developed using a modified Delphi technique method, involving a steering group (9 participants), a rating group (28 participants) and a peer-review group (31 participants). Nine statements were generated and then debated during a SIGASCOT consensus meeting. A manuscript has been then developed to report methodology and results of the consensus process and finally approved by all steering group members. Results: A different level of consensus has been reached among the topics selected. Strong agreement has been reported in considering harvesting, treatment and conservation methods relevant for clinical results, and in considering biological integration longer in allograft compared to autograft. Relative agreement has been reported in using allograft as the first-line graft for revision ACL-R, in considering biological integration a crucial aspect for rehabilitation protocol set-up, and in recommending a delayed return to sport when using allograft. Relative disagreement has been reported in using allograft as the first-line graft for primary ACL-R in patients over 50, and in not considering clinical results of allograft superior to autograft. Strong disagreement has been reported in using allograft as the first-line graft for primary ACL-R and for skeletally immature patients. Conclusions: Results of this consensus do not represent a guideline for surgeons, but could be used as starting point for an international discussion on use of allografts in ACL-R. Level of evidence: IV, consensus of experts.
KW - ACL reconstruction
KW - ACL revision
KW - Allograft
KW - Anterior cruciate ligament
KW - Autograft
KW - Consensus
KW - Knee
KW - Pediatric
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U2 - 10.1007/s00167-018-5003-6
DO - 10.1007/s00167-018-5003-6
M3 - Article
AN - SCOPUS:85047905330
SP - 1
EP - 9
JO - Knee Surgery, Sports Traumatology, Arthroscopy
JF - Knee Surgery, Sports Traumatology, Arthroscopy
SN - 0942-2056
ER -