Evidence map›Paper›PMID 38295088›Full record

SynthesisPloS one2024

The effectiveness of acellular nerve allografts compared to autografts in animal models: A systematic review and meta-analysis.

Berend O Broeren, Caroline A Hundepool, Ali H Kumas, Liron S Duraku, Erik T Walbeehm, Carlijn R Hooijmans, Dominic M Power, J Michiel Zuidam, Tim De Jong

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
4.6field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Berend O BroerenDepartment of Plastic & Reconstructive Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID 0000-0002-0198-8941
Caroline A HundepoolDepartment of Plastic & Reconstructive Surgery, Erasmus MC, Rotterdam, The Netherlands.
Ali H KumasDepartment of Plastic & Reconstructive Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
Liron S DurakuDepartment of Plastic, Reconstructive & Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands.
Erik T WalbeehmDepartment of Plastic, Reconstructive & Hand Surgery, Haga Hospital and Xpert Clinic, Den Haag, The Netherlands.ORCID 0000-0002-5319-2224
Carlijn R HooijmansDepartment for Health Evidence Unit SYRCLE, Radboud University Medical Centre, Nijmegen, The Netherlands.
Dominic M PowerDepartment of Hand & Peripheral Nerve Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom.
J Michiel ZuidamDepartment of Plastic & Reconstructive Surgery, Erasmus MC, Rotterdam, The Netherlands.
Tim De JongDepartment of Plastic & Reconstructive Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
Radboud University Nijmegen · NLErasmus MC · NLAmsterdam University Medical Centers · NLHaga Hospital · NLQueen Elizabeth Hospital Birmingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTreatment of nerve injuries proves to be a worldwide clinical challenge. Acellular nerve allografts are suggested to be a promising alternative for bridging a nerve gap to the current gold standard, an autologous nerve graft.

objectiveTo systematically review the efficacy of the acellular nerve allograft, its difference from the gold standard (the nerve autograft) and to discuss its possible indications. MATERIAL AND

methodsPubMed, Embase and Web of Science were systematically searched until the 4th of January 2022. Original peer reviewed paper that presented 1) distinctive data; 2) a clear comparison between not immunologically processed acellular allografts and autologous nerve transfers; 3) was performed in laboratory animals of all species and sex. Meta analyses and subgroup analyses (for graft length and species) were conducted for muscle weight, sciatic function index, ankle angle, nerve conduction velocity, axon count diameter, tetanic contraction and amplitude using a Random effects model. Subgroup analyses were conducted on graft length and species.

resultsFifty articles were included in this review and all were included in the meta-analyses. An acellular allograft resulted in a significantly lower muscle weight, sciatic function index, ankle angle, nerve conduction velocity, axon count and smaller diameter, tetanic contraction compared to an autologous nerve graft. No difference was found in amplitude between acellular allografts and autologous nerve transfers. Post hoc subgroup analyses of graft length showed a significant reduced muscle weight in long grafts versus small and medium length grafts. All included studies showed a large variance in methodological design.

conclusionOur review shows that the included studies, investigating the use of acellular allografts, showed a large variance in methodological design and are as a consequence difficult to compare. Nevertheless, our results indicate that treating a nerve gap with an allograft results in an inferior nerve recovery compared to an autograft in seven out of eight outcomes assessed in experimental animals. In addition, based on our preliminary post hoc subgroup analyses we suggest that when an allograft is being used an allograft in short and medium (0-1cm, > 1-2cm) nerve gaps is preferred over an allograft in long (> 2cm) nerve gaps.

Indexed as

Nerve RegenerationSciatic NerveAllograftsAnimalsAutograftsTransplantation, AutologousTransplantation, Homologous

Identifiers

PMID38295088
PMCPMC10829984
OpenAlexW4391382604

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.