Suijkerbuijk Mathijs A M, Reijman Max, Lodewijks Susanne J M, Punt Jorien, Meuffels Duncan E
Department of Orthopaedic Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
Department of Orthopaedic Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
Am J Sports Med. 2015 Oct;43(10):2591-8. doi: 10.1177/0363546514562169. Epub 2014 Dec 29.
Hamstring tendons are often used as autografts for anterior cruciate ligament (ACL) reconstruction. However, no systematic review has been performed describing consequences such as hamstring tendon regeneration rate and determinants of hamstring tendon regeneration.
To summarize the current literature regarding hamstring tendon rate regeneration, the time course of regeneration, and determinants of hamstring regeneration.
Systematic review.
A search was performed in the Embase, Medline (OvidSP), Web of Science, Cochrane, PubMed, and Google Scholar databases up to June 2014 to identify relevant articles. A study was eligible if it met the following inclusion criteria: tendons were harvested, regeneration at harvest site was assessed, population size was at least 10 human subjects, full-text article was available, and the study design was either a randomized controlled trial, prospective cohort study, retrospective cohort study, or case control study. A risk of bias assessment of the eligible articles was determined. Data describing hamstring tendon regeneration rates were pooled per time period.
A total of 18 publications met the inclusion criteria. The mean regeneration rate for the semitendinosus and gracilis tendons was, in all cases, 70% or higher. More than 1 year after harvesting, 79% (median [IQR], 80 [75.5-90]) of the semitendinosus tendons and 72% (median [IQR], 80 [61-88.5]) of the gracilis tendons were regenerated. No significant differences in regeneration rate could be found considering patient sex, age, height, weight, or duration of immobilization. Results did not clearly show whether absence of regeneration disadvantages the subsequent hamstring function. Five studies measured the regeneration rate at different moments in time.
Hamstring tendons regenerated in the majority of patients after ACL reconstruction. The majority of the hamstring tendon regeneration was found to occur between 1 month and 1 year after harvest. No significant determinants for hamstring tendon regeneration could be identified because of a lack of research. The function and strength of the regenerated hamstring remained unclear.
腘绳肌腱常被用作前交叉韧带（ACL）重建的自体移植物。然而，尚未有系统评价描述腘绳肌腱再生率等后果以及腘绳肌腱再生的决定因素。
总结目前关于腘绳肌腱再生率、再生时间进程以及腘绳肌再生决定因素的文献。
系统评价。
截至2014年6月，在Embase、Medline（OvidSP）、科学网、Cochrane、PubMed和谷歌学术数据库中进行检索，以识别相关文章。若研究符合以下纳入标准则 eligible：采集肌腱、评估采集部位的再生情况、研究对象数量至少为10名人类受试者、有全文文章且研究设计为随机对照试验、前瞻性队列研究、回顾性队列研究或病例对照研究。对 eligible 文章进行偏倚风险评估。按时间段汇总描述腘绳肌腱再生率的数据。
共有18篇出版物符合纳入标准。在所有病例中，半腱肌和股薄肌腱的平均再生率均为70%或更高。采集后1年多，79%（中位数[四分位间距]，80[75.5 - 90]）的半腱肌和72%（中位数[四分位间距]，80[61 - 88.5]）的股薄肌腱实现了再生。考虑患者性别、年龄、身高、体重或固定时间，再生率未发现显著差异。结果未明确显示再生缺失是否会对后续腘绳肌功能产生不利影响。五项研究在不同时间点测量了再生率。
ACL重建术后大多数患者的腘绳肌腱实现了再生。大多数腘绳肌腱再生发生在采集后1个月至1年之间。由于缺乏研究，无法确定腘绳肌腱再生的显著决定因素。再生腘绳肌的功能和强度仍不清楚。
