Yang Rui, Deng Haiquan, Hou Jingyi, Ouyang Yi, Chen Zhong, Song Bin, Zhou Yunfeng, Tan Weiquan, Li Weiping, Shen Huiyong
Orthopedics. 2017 Sep 1;40(5):e892-e897. doi: 10.3928/01477447-20170824-02. Epub 2017 Sep 7.
This study compared knee stability and alterations in the composition of synovial fluid among patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction with either a hamstring autograft or a hamstring allograft. This prospective cohort study enrolled 175 patients. Of these patients, 90 underwent hamstring tendon autograft ACL reconstruction. The remaining patients (n=85) underwent hamstring tendon allograft ACL reconstruction. All of the patients had a minimum of 1 year of follow-up (mean, 2.5 years). Side-to-side differences and the proportion of mononuclear cells in knee joint synovial fluid were measured at 5 time points (preoperatively and at postoperative weeks 1, 3, 6, and 12). During the early postoperative phase, side-to-side knee laxity was greater among the allograft group compared with the autograft group (P<.001). Additionally, among the allograft group, the proportion of mononuclear cells remained high at weeks 6 and 12 (mean, 90.0% and 88.9%, respectively) compared with a normal level in the autograft group (mean, 45.1% and 65.7%, separately). However, no significant difference was found between the 2 groups at final follow-up for range of motion, results of the Lachman test, results of the anterior drawer test, results of the pivot shift test, Lysholm score, bone tunnel enlargement, and graft failure rate (P>.05). These findings showed that, in the early postoperative phase, ACL reconstruction with a hamstring allograft resulted in greater knee laxity and immunologic response compared with the hamstring autograft group. However, at relatively long-term follow-up, both grafts achieved similar objective and subjective outcomes. [Orthopedics. 2017; 40(5):e892-e897.].
本研究比较了接受自体腘绳肌腱或异体腘绳肌腱关节镜下前交叉韧带（ACL）重建的患者的膝关节稳定性及滑液成分变化。这项前瞻性队列研究纳入了175例患者。其中，90例接受了自体腘绳肌腱ACL重建。其余患者（n = 85）接受了异体腘绳肌腱ACL重建。所有患者至少随访1年（平均2.5年）。在5个时间点（术前以及术后第1、3、6和12周）测量膝关节滑液的左右差异和单核细胞比例。术后早期，异体移植组的膝关节左右松弛度大于自体移植组（P <.001）。此外，异体移植组在第6周和第12周时单核细胞比例仍较高（分别平均为90.0%和88.9%），而自体移植组处于正常水平（分别平均为45.1%和65.7%）。然而，在末次随访时，两组在活动范围、Lachman试验结果、前抽屉试验结果、轴移试验结果、Lysholm评分、骨隧道扩大情况和移植物失败率方面未发现显著差异（P >.05）。这些结果表明，在术后早期，与自体腘绳肌腱组相比，异体腘绳肌腱ACL重建导致更大的膝关节松弛度和免疫反应。然而，在相对长期的随访中，两种移植物均取得了相似的客观和主观结果。[《骨科学》。2017；40(5):e892 - e897。]
