Ref. | Methodology | Results | Quality |
---|---|---|---|
Structural allografts versus cortical autologous grafts in hindfoot OTs | |||
Dolan et al. [51] | Randomized controlled trial | Rate of union at 8 weeks | No concealed allocation No blinded outcome assessment 100% FU Underpowered study |
18 freeze-dried structural allografts vs. 15 cortical autologus grafts in 31 adults undergoing Evan’s OTs. FU: 8 and 12 weeks | Allografts: 17/18 (94%) | ||
Autologous grafts: 9/15 (60%), P = 0.03 | |||
Rate of union at 12 weeks | |||
100% for allografts and autologous grafts | |||
No graft collapse in both groups | |||
Templin et al. [52] | Retrospective comparative chart review (1994–2003) | Rate of union | Selection: *** |
Allografts: 27/30 (90%) | Comparability: | ||
30 freeze-dried structural allografts vs 5 structural autologous grafts in 35 children undergoing Evan’s OTs. Mean FU 3.6 years (range 6–12 years) | Autologous grafts: 4/5 (80%) | Outcome: * | |
P = n. s. | |||
Kwak et al. [53] | Retrospective comparative chart review (2000–2005) | Talo-1 st metatarsal, talo-calcaneal and calcaneal pitch angle at final FU | Selection: *** |
Comparability: | |||
118 acellular allografts (Tutoplast ®) vs. 10 structural autologous grafts in 79 children undergoing Evan’s OTs. Mean FU 15 months (range 13-21months) | No significant difference between the two graft types | Outcome: * | |
Structural allografts versus cortical autologous grafts in hindfoot ADs | |||
Easley et al. [4] | Subgroup comparison in a retrospective chart review (1988–1995) | Rate of union | Selection: *** |
Allografts: 2/5 (40%) | Comparability: | ||
5 structural allografts vs. 29 structural autologous grafts in isolated subtalar ADs. Mean FU 51 months (range 24–130 months) | Autologous grafts: 24/29 (83%) | Outcome: * | |
P = n.s. | |||
Time to union | |||
Autologous grafts: 16 weeks (10-30 weeks) | |||
P = n. s. | |||
Structural allografts versus cortical autologous grafts in miscellaneous procedures (hindfoot ADs/OTs) | |||
Grier et al.[54] | Retrospective comparative chart review (1996–2006) | Rate of union | Selection: ** |
Allografts + PRP: 29/31 (94%) | Comparability: | ||
31 structural freeze-dried allografts + PRP vs. 20 structural autologous grafts in 18 adult Evan’s OTs and 33 adult CC ADs. Mean FU: 20 months (range 3-72 months) | Autologous grafts: 14/20 (70%) | Outcome: * | |
P = 0.045 | Â | ||
Improvement of the talo-1 st metatarsal and calcaneal pitch angle | |||
No significant difference between the two graft types | |||
Danko et al. [17] | Retrospective comparative chart review (1990–1992) | Graft collapse | Selection: *** |
Evan’s OT: | Comparability: | ||
7 structural allografts vs 33 structural autologous grafts in 69 pediatric Evan’s OTs and 61 pediatric CC ADs. Mean FU 2.5 years (range 0.6-7.8 years) | Allografts: 0/39 | Outcome: *** | |
Autologous grafts 0/30 | |||
P = ? | |||
CC ADs: | |||
Allografts: 17/58 (29%) | |||
Autologous grafts: 0/3 (0%) | |||
P = ? | |||
Mahan et al.[55] | Retrospective comparative chart review (1977–1990) | Rate of union | Selection: ** |
Allografts: 198/215 | Comparability: | ||
215 freeze dried allografts vs 85 autologous grafts in 153 OTs, 55 ADs, 82 other procedures. Minimum FU 6 weeks | (92%) | Outcome: * | |
Autologous grafts: 78 /85 (92%), | |||
P = n. s. | |||
Rate of delayed union | |||
Allografts: 8/215 (4%) | |||
Autologous grafts 2/85 (2%) | |||
P = n. s. |