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Impact of irradiation on load-to-failure in bone-patellar tendon-bone allografts: A systematic review and
Kelly M Chandler1, Sam Schick1, Mathew Hargreaves1
1University of Alabama at Birmingham Department of Orthopaedic Surgery, Birmingham, AL, USA.
Introduction:
To evaluate the impact various levels of irradiation have on bone-patellar tendon-bone (BTB) allograft load-to-failure.
Materials And Methods:
Pubmed, Google Scholar and Embase were searched for studies reporting load-to-failure measurements of BTB allografts following gamma or eBeam irradiation. All systematic reviews, editorials, as well as studies that utilized animal models and/or other graft sources (achilles, hamstring, quadriceps) were excluded. Meta-analysis was performed to compare the impact of low dose (19 ≤ kGy), intermediate (20-49 kGy) and high dose (>50 kGy) gamma and eBeam radiation on load-to-failure.
Results:
Twelve studies, containing a total of 429 BTB allografts (159 controls, 270 irradiated), were identified. Load-to-failure of BTB allograft was significantly decreased at intermediate (20-49 kGy) doses of radiation, while low (≤19 kGy) and high (>50 kGy) doses did not significantly change load-to-failure.
Conclusions:
Intermediate doses of radiation may negatively impact the biomechanical integrity of BTB allograft in vitro. Future studies are required to examine clinical outcomes at varying irradiation levels.
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