Tom James A, Rodeo Scott A
Sports Medicine and Shoulder Service, The Hospital for Special Surgery, New York, NY 10021, USA.
Clin Orthop Relat Res. 2002 Sep(402):135-56. doi: 10.1097/00003086-200209000-00012.
Soft tissue allografts are an important substitute tissue for the reconstruction of deficient ligaments, torn menisci, and osteochondral defects during knee surgery. Interest in allografts for soft tissue reconstruction has arisen from the demand to obtain a stable knee with restoration of function and protection against additional injury. Use of allografts for soft tissue reconstruction is associated with less donor tissue site morbidity and reduced surgical time. Nevertheless, use of allografts has a potential for disease transmission, delayed graft incorporation, and host versus donor immunologic response to the graft. Experimental studies and animal models have provided information about the biologic aspects of graft incorporation and remodeling and have contributed to the development of methods of graft preparation and transplantation. Clinical studies of allograft transplantation in humans have helped to define surgical indications and techniques and have allowed for the assessment of clinical outcome. The current authors review the current literature concerning the basic and clinical principles of soft tissue allografts for knee reconstruction, and underscore the scientific basis for the clinical application of allograft tissue during knee surgery.
软组织同种异体移植物是膝关节手术中用于重建韧带缺损、半月板撕裂和骨软骨缺损的重要替代组织。对软组织重建同种异体移植物的兴趣源于获得功能恢复且稳定的膝关节以及预防额外损伤的需求。软组织重建使用同种异体移植物与供体组织部位发病率较低和手术时间缩短相关。然而,使用同种异体移植物存在疾病传播、移植物整合延迟以及宿主对移植物的供体免疫反应的可能性。实验研究和动物模型提供了有关移植物整合和重塑生物学方面的信息,并有助于移植物制备和移植方法的发展。人类同种异体移植的临床研究有助于确定手术适应症和技术,并允许评估临床结果。本文作者回顾了有关膝关节重建软组织同种异体移植物的基础和临床原则的当前文献,并强调了膝关节手术中同种异体组织临床应用的科学依据。