Department of Orthopaedic Surgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
Department of Orthopaedic Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
Knee Surg Sports Traumatol Arthrosc. 2018 Apr;26(4):1281-1287. doi: 10.1007/s00167-017-4649-9. Epub 2017 Jul 26.
Using second-look arthroscopy, graft maturation was investigated and compared between hamstring (HA) autografts and tibialis anterior (TA) allografts after anatomic single-bundle anterior cruciate ligament reconstruction (ACLR).
Fifty-six patients who underwent second-look arthroscopy after anatomic single-bundle ACLR with either HA autografts (26, HA group) or TA allografts (30, TA group) from 2007 to 2016 were retrospectively reviewed. Graft maturation on second-look arthroscopy was evaluated in terms of four parameters: graft integrity (tear), synovial coverage, graft tension, and graft vascularization. Each parameter received a maximum of two points, depending on the status of the reconstructed graft. The total graft maturation score was calculated as the sum of the parameter scores. The total graft maturation and individual parameter scores were compared between the two groups.
The mean time from ACLR to second-look arthroscopy was 22.5 ± 7.8 months. The maturation scores in the HA group were significantly better in terms of graft integrity (p = 0.041), graft tension (p = 0.010), and graft vascularization (p = 0.024), whereas the graft synovial coverage score was not significantly different. The total graft maturation score of the HA group was significantly higher than that of the TA group (6.3 ± 0.4 vs. 4.9 ± 0.3, p = 0.013).
This study shows the superior graft maturation of HA autografts compared with that of TA allografts at a mean follow-up of 22.5 ± 7.8 months after anatomic single-bundle ACLR. When anatomic ACLR using soft tissue graft is planned, HA autograft is recommended rather than soft tissue allograft, especially in young and active patients.
Retrospective cohort review, Level III.
通过二次关节镜检查，研究并比较了解剖学单束前交叉韧带重建（ACLR）后，腘绳肌腱（HA）自体移植物和胫骨前肌（TA）同种异体移植物的移植物成熟情况。
回顾性分析了 2007 年至 2016 年间接受解剖学单束 ACLR 的 56 例患者，其中 26 例（HA 组）采用 HA 自体移植物，30 例（TA 组）采用 TA 同种异体移植物。在二次关节镜检查中，通过 4 个参数评估移植物成熟情况：移植物完整性（撕裂）、滑膜覆盖、移植物张力和移植物血管化。根据重建移植物的状态，每个参数的评分最高为 2 分。总移植物成熟评分计算为各参数评分之和。比较两组之间的总移植物成熟评分和各参数评分。
从 ACLR 到二次关节镜检查的平均时间为 22.5±7.8 个月。HA 组在移植物完整性（p=0.041）、移植物张力（p=0.010）和移植物血管化（p=0.024）方面的成熟评分明显更好，而滑膜覆盖评分无明显差异。HA 组的总移植物成熟评分明显高于 TA 组（6.3±0.4 比 4.9±0.3，p=0.013）。
本研究显示，在解剖学单束 ACLR 后平均 22.5±7.8 个月的随访中，HA 自体移植物的移植物成熟情况明显优于 TA 同种异体移植物。当计划进行解剖学 ACLR 时，建议使用 HA 自体移植物而不是软组织同种异体移植物，尤其是在年轻且活跃的患者中。
回顾性队列研究，III 级。
