Keizer M N J, Otten E
Center for Human Movement Science, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Musculoskelet Surg. 2019 Aug;103(2):121-130. doi: 10.1007/s12306-018-0572-6. Epub 2018 Oct 16.
Anterior tibia translation (ATT) is mainly prevented by the anterior cruciate ligament. Passive ATT tests are commonly used to diagnose an anterior cruciate ligament (ACL) injury, to select patients for an ACL reconstruction (ACLR), and as an outcome measure after an ACLR. The aim of this review was to present an overview of possible factors determining ATT. A second purpose was to give a summary of the ATT measured in the literature in healthy, ACL-injured and ACLR knees and a comparison between those groups. A literature search was conducted with PubMed. Inclusion criteria were full-text primary studies published in English between January 2006 and October 2016. Studies included reported ATT in explicit data in healthy as well as ACL-injured or ACLR knees or in ACL-injured as well as ACLR knees. Sixty-one articles met inclusion criteria. Two articles measured the ATT in healthy as well as ACL-injured knees, 51 in ACL-injured as well as in ACLR knees, three in ACLR as well as in healthy knees and three in healthy, ACL-injured and ACLR knees. A difference in ATT is found between healthy, contralateral, ACLR and ACL-injured knees and between chronic and acute ACL injury. Graft choices and intra-articular injuries are factors which could affect the ATT. The mean ATT was lowest to highest in ACLR knees using a bone-patella tendon-bone autograft, ACLR knees using a hamstring autograft, contralateral healthy knees, healthy knees, ACLR knees with an allograft and ACL-injured knees. Factors which could affect the ATT are graft choice, ACL injury or reconstruction, intra-articular injuries and whether an ACL injury is chronic or acute. Comparison of ATT between studies should be taken with caution as a high number of different measurement methods are used. To be able to compare studies, more consistency in measuring devices used should be introduced to measuring ATT. The clinical relevance is that an autograft ACLR might give better results than an allograft ACLR as knee laxity is greater when using an allograft tendon. LEVEL OF EVIDENCE: III.
胫骨前移（ATT）主要由前交叉韧带防止。被动ATT测试常用于诊断前交叉韧带（ACL）损伤、选择进行ACL重建（ACLR）的患者以及作为ACLR后的一项结果指标。本综述的目的是概述决定ATT的可能因素。第二个目的是总结在健康、ACL损伤和ACLR膝关节中测量到的ATT，并对这些组进行比较。使用PubMed进行了文献检索。纳入标准为2006年1月至2016年10月期间以英文发表的全文原始研究。纳入的研究报告了健康以及ACL损伤或ACLR膝关节明确数据中的ATT，或ACL损伤以及ACLR膝关节中的ATT。61篇文章符合纳入标准。两篇文章测量了健康以及ACL损伤膝关节中的ATT，51篇测量了ACL损伤以及ACLR膝关节中的ATT，三篇测量了ACLR以及健康膝关节中的ATT，三篇测量了健康、ACL损伤和ACLR膝关节中的ATT。在健康、对侧、ACLR和ACL损伤膝关节之间以及慢性和急性ACL损伤之间发现了ATT的差异。移植物选择和关节内损伤是可能影响ATT的因素。使用骨-髌腱-骨自体移植物的ACLR膝关节、使用腘绳肌自体移植物的ACLR膝关节、对侧健康膝关节、健康膝关节、使用同种异体移植物的ACLR膝关节和ACL损伤膝关节的平均ATT从低到高排列。可能影响ATT的因素包括移植物选择、ACL损伤或重建、关节内损伤以及ACL损伤是慢性还是急性。由于使用了大量不同的测量方法，在比较研究之间的ATT时应谨慎。为了能够比较研究，在测量ATT时应引入更多测量设备的一致性。临床意义在于，自体移植物ACLR可能比同种异体移植物ACLR产生更好的结果，因为使用同种异体肌腱时膝关节松弛度更大证据级别：III级。
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