Six non-randomised controlled trials (n=534) were included in the review. The sample sizes ranged from 60-268.
There were significantly more graft ruptures in the allograft group compared to the autograft group (5 studies, OR 5.03, 95% CI: 1.38, 18.33, p=0.01) with no evidence of statistically significant heterogeneity.
Significantly more participants in the autograft group were able to perform a hop test of greater than 90% of the non-operative side (3 studies, OR 5.66, 95%CI: 3.09, 10.36, p<0.01). Again, there was no evidence of statistically significant heterogeneity.
There was no statistically significant difference between the autograft and allograft groups in terms of the Lachman examination and the IKDC score. However, both these outcomes exhibited statistically significant heterogeneity (Q statistic: 17.4, p<0.01, and Q statistic: 26.7, p<0.01 respectively).
There was no statistically significant difference between the allograft and autograft groups and no evidence of statistically significant heterogeneity for the remaining outcomes of rate of reoperation, pivot shift scores, absence versus presence of patellofemoral crepitus and return to pre-injury activity level.
Sensitivity analysis performed by excluding one trial (the largest one), which used a different technique for preparing and sterilising the allografts (radiation and acetone drying), resulted in the absence of statistically significant heterogeneity for all outcome measures. It showed that there was no statistically significant difference between autografts and allografts with respect to graft rupture (OR and CI not reported, p=0.37) or hop test greater than 90% of the non-operative side (OR and CI not reported, p=0.34).