No Difference in Most Reported Outcome Measures for Allograft Versus Autograft for Hip Labral Reconstruction: A Systematic Review of Comparative Studies

Muzammil Akhtar; Daniel Razick; Osamah Baig; Sonia Aamer; Shaheryar Asad; Carter Bernal; Anand Dhaliwal; Trevor Shelton

doi:10.1016/j.arthro.2024.01.041

No Difference in Most Reported Outcome Measures for Allograft Versus Autograft for Hip Labral Reconstruction: A Systematic Review of Comparative Studies

Arthroscopy. 2024 Feb 8:S0749-8063(24)00097-5. doi: 10.1016/j.arthro.2024.01.041. Online ahead of print.

Authors

Muzammil Akhtar¹, Daniel Razick², Osamah Baig³, Sonia Aamer², Shaheryar Asad², Carter Bernal², Anand Dhaliwal², Trevor Shelton⁴

Affiliations

¹ California Northstate University College of Medicine, Elk Grove, California, U.S.A.. Electronic address: makhtar@ucdavis.edu.
² California Northstate University College of Medicine, Elk Grove, California, U.S.A.
³ Lake Erie College of Osteopathic Medicine, Erie, Pennsylvania, U.S.A.
⁴ Utah Valley Orthopedics and Sports Medicine, Intermountain Health, Provo, Utah, U.S.A.

PMID: 38336107
DOI: 10.1016/j.arthro.2024.01.041

Abstract

Purpose: To systematically review studies comparing outcomes of allograft versus autograft for hip labral reconstruction.

Methods: A systematic review following guidelines established by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) was performed in 3 databases using the terms "labrum," "hip," "acetabulum," "reconstruction," "augmentation," "allograft," and "autograft." Data on study characteristics, patient demographic characteristics, follow-up time, patient-reported outcomes (PROs), rates of revision surgery, and rates of conversion to total hip arthroplasty (THA) were collected.

Results: Three studies were included, with Methodological Index for Non-randomized Studies (MINORS) scores ranging from 17 to 23. Among 92 patients receiving allografts, the mean ages ranged from 30.6 to 34.8 years; mean follow-up times, from 34.6 to 66.1 months; revision rates, from 0% to 23.6%; and conversion-to-THA rates, from 0% to 20%. Among 185 patients receiving autografts, the mean ages ranged from 34.6 to 35.9 years; mean follow-up times, from 32.7 to 80.8 months; revision rates, from 0% to 7.3%; and conversion-to-THA rates, from 0% to 6.7%. One study reported significantly higher revision rates in the allograft group. All studies reported no statistically significant differences in postoperative PROs, and all postoperative PROs significantly improved compared with preoperative PROs. Rates of achievement of the minimal clinically important difference and patient acceptable symptomatic state, reported by 1 study, were statistically similar between the 2 groups and ranged from 55.6% to 100% for the allograft group and from 53.8% to 84.6% for the autograft group.

Conclusions: There were no significant differences between allograft and autograft patients in terms of postoperative PROs; however, all PRO measures were slightly higher in allograft patients. Both revision and conversion-to-THA rates were higher in allograft patients in 2 studies, with the level of significance being reached in terms of revision in 1 study. The third study reported zero revisions and conversions to THA in allograft and autograft patients.

Level of evidence: Level III, systematic review of Level II and III studies.

Publication types

Review