First and foremost, the authors thank Dr. Yang et al. for their careful reading of our systematic review. After closer examination, we agree that the investigation by Sun et al.
1
warranted inclusion and may have been inadvertently excluded because of the use of irradiated allografts. Additionally, the effect of duplicate publication bias must be acknowledged in comparative studies with updated follow-up.2
, 3
Although negative results are underemphasized in the current literature, the selected studies in our review largely indicate a lack of statistically significant differences between autograft and nonirradiated, nonchemically treated allografts on specific clinical end points. Interestingly, Mariscalco et al.4
recently performed a similar systematic review and also failed to demonstrate any significant differences in graft failure rate, laxity measures, patient-reported outcome scores, or combinations of these factors.Heterogeneity was also assessed in the current study but not featured in the final publication. Similarly, the authors agree sensitivity analysis offers meaningful information in selected studies, and this methodology has been used in our previous publications evaluating outcomes after anterior cruciate ligament reconstruction.
5
, 6
Again, the authors would like to thank you for your interest in our work.
References
- Anterior cruciate ligament reconstruction with BPTB autograft, irradiated versus non-irradiated allograft: A prospective randomized clinical study.Knee Surg Sports Traumatol Arthrosc. 2009; 17: 464-474
- Autograft versus allograft anterior cruciate ligament reconstruction.Arthroscopy. 1997; 13: 446-449
- Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction: A 5-year follow-up.Arthroscopy. 2001; 17: 9-13
- Autograft versus nonirradiated allograft tissue for anterior cruciate ligament reconstruction: A systematic review.Am J Sports Med. 2013 Aug 8; ([Epub ahead of print])
- Operative versus nonoperative treatment of anterior cruciate ligament rupture in patients aged 40 years or older: an expected-value decision analysis.Arthroscopy. 2008; 24: 914-920
- Allograft versus autograft decision for anterior cruciate ligament reconstruction: An expected-value decision analysis evaluating hypothetical patients.Arthroscopy. 2012; 28: 539-547
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- Comment on Anterior Cruciate Ligament Reconstruction with Autografts Compared With Non-Irradiated Non-Chemically Treated AllograftsArthroscopyVol. 30Issue 4
- PreviewWe read with deep interest the recent article by Lamblin et al.,1 “Anterior Cruciate Ligament Reconstruction with Autografts Compared with Non-Irradiated Non-Chemically Treated Allografts.” This is an excellent job that we really appreciate. However, after reading the paper very carefully, we also found some worthwhile issues worth being explored.
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