Li ShuZhen, Su Wei, Zhao Jinmin, Xu Yinglong, Bo Zhandong, Ding Xiaofei, Wei Qingjun
Department of Orthopaedics Trauma and Hand Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530027, China.
Knee. 2011 Oct;18(5):287-93. doi: 10.1016/j.knee.2010.08.002. Epub 2010 Sep 17.
The objective of this study was to evaluate the effectiveness of hamstring (HT) autografts versus bone-patellar tendon-bone (BPTB) autografts for reconstruction of the anterior cruciate ligament (ACL). We searched the Cochrane Library, MEDLINE, EMBASE and the Chinese Biomedicine Database (CBM) for published randomised clinical trials (RCTs) relevant to ACL reconstruction comparing HT and BPTB autografts. Data analyses were performed with Cochrane Collaboration's RevMan 5.0. A total of 23 reports of 19 randomised controlled trials (RCTs) (1643 patients) met the inclusion criteria. Outcomes favouring BPTB autografts were found in terms of KT-1000 arithmometer values, negative rates of Lachman tests and negative rates of Pivot tests. Outcome measures that favoured HT autografts included anterior knee pain, kneeling pain and extension loss. There was no statistical difference of postoperative graft failure. Overall, postoperative complications of the knee joint were lower for HT autografts than for BPTB autografts, and BPTB autografts were superior to HT autografts in resuming stability of the knee joint, but four-strand HT combined with application of the modern endobutton HT graft-fixation technique could increase knee-joint stability.
本研究的目的是评估腘绳肌（HT）自体移植物与髌腱-骨（BPTB）自体移植物在前交叉韧带（ACL）重建中的有效性。我们检索了Cochrane图书馆、MEDLINE、EMBASE和中国生物医学数据库（CBM），以查找已发表的与比较HT和BPTB自体移植物的ACL重建相关的随机临床试验（RCT）。使用Cochrane协作网的RevMan 5.0进行数据分析。共有19项随机对照试验（RCT）（1643例患者）的23份报告符合纳入标准。在KT-1000测角计值、Lachman试验阴性率和轴移试验阴性率方面，发现有利于BPTB自体移植物的结果。有利于HT自体移植物的结果指标包括膝关节前方疼痛、跪姿疼痛和伸展受限。术后移植物失败无统计学差异。总体而言，HT自体移植物的膝关节术后并发症低于BPTB自体移植物，BPTB自体移植物在恢复膝关节稳定性方面优于HT自体移植物，但四股HT联合应用现代纽扣式HT移植物固定技术可增加膝关节稳定性。
