Allograft tissue irradiation and failure rate after anterior cruciate ligament reconstruction: A systematic review

Table 2 In vitro studies of non-irradiated and irradiated allograft tissue for anterior cruciate ligament reconstruction

Ref.	Year	Type of study	Graft type	Irradiation dose	Temperautre when irradiated	No. of samples	Age (yr)	Findings
Balsly et al[9]	2008	Laboratory	BPTB - low dose	1.83-2.18 Mrad	- 20 °C to -50 °C	9	18-55	There was a significant difference for: (1) BPTB - tensile strength in the moderate dose irradiation vs control groups (2) Fascia lata - modulus of elasticity in the moderate dose irradiation vs control groups
			BPTB - moderate dose	2.4-2.85 Mrad		9
			BPTB - control	None	N/A	9 controls for low dose
						9 controls moderate dose
			Anterior Tibialis - low dose	1.83-2.18 Mrad	- 20 °C to -50 °C	10	23-64	No significant difference between the tensile strength and modulus of elasticity for all other groups for low dose irradiation vs control and moderate dose irradiation vs control (other than stated above)
			Anterior Tibialis - moderate dose	2.4-2.85 Mrad		10
			Anterior Tibialis - control	None	N/A	10 controls for low dose
						10 controls for moderate dose
			Semitendinosus - low dose	1.83-2.18 Mrad	- 20 °C to -50 °C	8	16-54
			Semitendinosus - moderate dose	2.4-2.85 Mrad		10
			Semitendinosus - control	None	N/A	10 controls for low dose
						10 controls for moderate dose
			Fascia Lata - low dose	1.83-2.18 Mrad	- 20 °C to -50 °C	10	19-48
			Fascia Lata - moderate dose	2.4-2.85 Mrad		10
			Fascia Lata - control	None	N/A	10 controls for low dose
						10 controls for moderate dose
Greaves et al[17]	2008	Laboratory	Tibialis - single strand irradiated (age < 45)	1.46-1.8 Mrad	Dry ice temperatures	10 irradiated	< 45	No significant difference in failure loads for irradiated vs non-irradiated for each of the three age groups (midsubstance failure = any rupture within graft substance, grip failure = slip from 1 of tendon grips exposing serrated portion of tendon)
			Tibialis - single strand non-irradiated (age < 45)			10 non-irradiated
			Tibialis - double strand irradiated (age < 45)			10 irradiated
			Tibialis - double strand non-irradiated (age < 45)			10 non-irradiated
			Tibialis - single strand irradiated (age 46-55)			13 irradiated	46-55
			Tibialis - single strand non-irradiated (age 46-55)			13 non-irradiated
			Tibialis - double strand irradiated (age 46-55)			10 irradiated
			Tibialis - double strand non-irradiated (age 46-55)			10 non-irradiated
			Tibialis - single strand irradiated (age 56-65)			10 irradiated	56-65
			Tibialis - single strand non-irradiated (age 56-65)			10 non-irradiated
			Tibialis - double strand irradiated (age 56-65)			10 irradiated
			Tibialis - double strand non-irradiated (age 56-65)			10 non-irradiated
Baldini et al[34]	2012	Laboratory	Tibialis	2.0-2.8 Mrad	Not reported	15	41.8	There were no significant difference in stiffness, failure to load, and failure stress between the irradiated vs non-irradiated groups
				None		12	47.4
Yanke et al[35]	2013	Laboratory	BPTB	1.0-1.2 Mrad	Not reported	10	52 ± 11	There was a significant difference in stiffness between the irradiated vs non-irradiated groups but none found in strain and elongation
				None		10

BPTB: Bone patella tendon bone.