2023 ISAKOS Biennial Congress ePoster
Adverse Events And Complications Reported In Prospective Versus Retrospective Investigations Of ACLR with BTB Autograft: A Systematic Review
Garrett Jackson, MD, Chicago, IL UNITED STATES
Harkirat Jawanda, BS, Chicago, IL UNITED STATES
Enzo Salviato Mameri, MD, MSc, São Paulo, São Paulo BRAZIL
Zeeshan Khan, BA, Chicago, IL UNITED STATES
Johnathon Robert Mccormick, MD, Chicago, Illinois UNITED STATES
Derrick Michael Knapik, MD, Chesterfield, Missouri UNITED STATES
Nikhil N. Verma, MD, Chicago, IL UNITED STATES
Jorge Chahla, MD, PhD, Hinsdale, IL UNITED STATES
Rush University Medical Center, Chicago, IL, UNITED STATES
FDA Status Not Applicable
Summary
Retrospective studies underreport complications following ACLR with an ipsilateral BTB autograft. The incidence of postoperative complications is 7.9 times higher in prospective studies, which report an overall complication rate of 13.5%, with a 6.2% rate of graft failure, 2.6% reoperation, and 1.2% infection rates.
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Abstract
Purpose
To evaluate differences in the incidence of reported postoperative complications and adverse events following primary ACLR using ipsilateral BTB autograft reported in retrospective versus prospective investigations.
Methods
A literature search was performed using PubMed, Embase, MEDLINE, and Cochrane library databases using the following terms combined with Boolean operators: ‘Bone Tendon Bone’; ‘Autograft’; ‘Patellar Tendon’; ‘Anterior Cruciate Ligament’; and ‘Reconstruction’. The inclusion criteria consisted of level I to III human clinical investigations reporting complications following primary ACLR using ipsilateral BTB autograft. Exclusion criteria consisted of: studies including revision ACLR or using alternative grafts, cadaveric studies, animal studies, review articles, expert opinions, case reports, non-English language studies without English translation, and studies in which the presence or absence of complications were not reported.
Results
Fifty-six studies, consisting of 26,637 patients, with a mean age of 26.7 years (range, 13 – 84 years) were identified. The overall incidence of reported complications in prospective studies (13.5%; n=929/6903) was 7.9 times greater when compared to retrospective (1.7%; n=335/19734 patients) studies (p < .001). The reported incidence of total graft failures, reoperations, infection, residual laxity, post-operative arthrofibrosis, and development of degenerative changes were significantly higher in the prospective studies (all, p < .05). The presence of degenerative changes (224 of 929; 24.1%) and persistent anterior knee pain (209 of 929; 22.5%) were the most commonly reported complications in prospective studies, while osteoarthritic development (61 of 335; 18.2%) and postoperative pain (21 of 335; 6.3%) were most commonly reported in retrospective studies.
Conclusion
Retrospective studies underreport complications following ACLR with an ipsilateral BTB autograft. The incidence of postoperative complications is 7.9 times higher in prospective studies, which report an overall complication rate of 13.5%, with a 6.2% rate of graft failure, 2.6% reoperation, and 1.2% infection rates.