Bach Bernard R, Aadalen Kirk J, Dennis Michael G, Carreira Dominic S, Bojchuk John, Hayden Jennifer K, Bush-Joseph Charles A
Section of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Am J Sports Med. 2005 Feb;33(2):284-92. doi: 10.1177/0363546504267347.
There are conflicting reports of allograft performance, immune response, tissue incorporation, and rerupture rates when used for anterior cruciate ligament reconstruction.
To evaluate the clinical outcome of a fresh-frozen, nonirradiated, patellar tendon allograft for primary anterior cruciate ligament reconstruction surgery.
Case series; Level of evidence, 4.
Patients who underwent endoscopic primary anterior cruciate ligament reconstruction with allograft tissue a minimum of 2 years ago were evaluated with physical examinations, the KT-1000 arthrometer, functional testing, radiographic evaluation, subjective assessment, and outcomes tools.
Fifty-nine patients (60 knees) were evaluated at an average of 51 months after surgery. Ninety-four percent of patients were mostly or completely satisfied. A negative pivot shift test result was noted in 90% of subjects. The KT-1000 arthrometer side-to-side differences were < or =3 mm in 95% of patients, and no patient exceeded 5 mm. The mean International Knee Documentation Committee score was 78 (SD = 19), and the mean Lysholm score was 82 (SD = 17). There were no clinical symptoms consistent with graft rejection or infection. Radiographic evaluation demonstrated infrequent significant tunnel widening.
Use of a fresh-frozen, nonirradiated allograft for primary reconstruction of the anterior cruciate ligament is a successful procedure both subjectively and functionally for restoring stability in patients selected for allograft reconstruction. In the patients selected for this surgical procedure, clinical, arthrometric stability testing, and subjective satisfaction were comparable to our previously published cohort studies using patellar tendon autograft at similar postoperative follow-up.
在用于前交叉韧带重建时，关于同种异体移植物的性能、免疫反应、组织整合及再断裂率的报道存在矛盾。
评估新鲜冷冻、未辐照的髌腱同种异体移植物用于初次前交叉韧带重建手术的临床疗效。
病例系列；证据等级，4级。
对至少在2年前接受同种异体组织内镜下初次前交叉韧带重建的患者进行体格检查、KT-1000关节测量仪检查、功能测试、影像学评估、主观评估及疗效工具评估。
平均在术后51个月对59例患者（60膝）进行了评估。94%的患者基本或完全满意。90%的受试者 pivot shift 试验结果为阴性。95%的患者KT-1000关节测量仪测量的两侧差异≤3 mm，无患者超过5 mm。国际膝关节文献委员会平均评分为78分（标准差 = 19），Lysholm平均评分为82分（标准差 = 17）。没有与移植物排斥或感染相符的临床症状。影像学评估显示很少有明显的隧道增宽。
对于选择同种异体移植物重建的患者，使用新鲜冷冻、未辐照的同种异体移植物进行前交叉韧带初次重建在主观和功能上都是恢复稳定性的成功方法。在选择进行该手术的患者中，临床、关节测量稳定性测试及主观满意度与我们之前发表的使用髌腱自体移植物且术后随访相似的队列研究相当。
