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供体年龄对髌腱同种异体移植重建前交叉韧带的影响。

Effect of donor age on patellar tendon allograft ACL reconstruction.

作者信息

Hampton Daniel M, Lamb Joshua, Klimkiewicz John J

机构信息

Department of Orthopaedics, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA.

出版信息

Orthopedics. 2012 Aug 1;35(8):e1173-6. doi: 10.3928/01477447-20120725-15.

Abstract

Anterior cruciate ligament reconstruction with patellar tendon allograft tissue is a common orthopedic procedure. It is unknown what effect, if any, the donor age has on clinical outcomes. Biomechanical studies have shown the strength of cadaveric patellar tendon to be independent of age, but no clinical studies have evaluated patient outcomes related to this variable. The purpose of this study was to evaluate the effect of allograft donor age on clinical outcomes of patients undergoing allograft anterior cruciate ligament reconstruction with patellar tendon allograft. Case logs were reviewed to identify primary anterior cruciate ligament reconstruction with allograft patellar tendon by a single surgeon using a standard endoscopic transtibial technique with interference screw fixation. Revision and multiligamentous surgeries were excluded. Seventy-seven patients who met these criteria were identified. Allografts were fresh-frozen, aseptically harvested patellar tendons from a single tissue bank. The donor age was obtained. Clinical outcomes were obtained by contacting patients by telephone and retrospective chart review. Pre- and postoperative Lysholm and Tegner knee scores were used for comparison.Data from 75 patients with an average follow-up of 24 months were obtained. Average donor age was 44 years (range, 14-65 years), and average patient age was 37 years (range, 18-60 years). Statistical analysis of pre- and postoperative Lysholm scores demonstrated statistically significant improvement (P≤.001). Using donor age as a continuous variable, no effect was found on postoperative improvement in Lysholm score or Tegner score (P=.6).

摘要

采用髌腱同种异体移植组织进行前交叉韧带重建是一种常见的骨科手术。目前尚不清楚供体年龄对临床结果是否有影响,如果有影响,其影响程度如何。生物力学研究表明,尸体髌腱的强度与年龄无关,但尚无临床研究评估与该变量相关的患者预后情况。本研究的目的是评估同种异体移植物供体年龄对接受同种异体髌腱移植进行前交叉韧带重建患者临床结果的影响。回顾病例记录,以确定由一名外科医生使用标准关节镜经胫骨技术并采用挤压螺钉固定进行的同种异体髌腱初次前交叉韧带重建手术。翻修手术和多韧带手术被排除在外。共确定了77例符合这些标准的患者。同种异体移植物为来自单一组织库的新鲜冷冻、无菌采集的髌腱。记录供体年龄。通过电话联系患者和回顾性查阅病历获取临床结果。使用术前和术后的Lysholm和Tegner膝关节评分进行比较。获得了75例患者的数据,平均随访时间为24个月。供体平均年龄为44岁(范围14 - 65岁),患者平均年龄为37岁(范围18 - 60岁)。对术前和术后Lysholm评分的统计分析显示有统计学意义的改善(P≤0.001)。将供体年龄作为连续变量,未发现其对术后Lysholm评分或Tegner评分的改善有影响(P = 0.6)。

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