自体移植物或同种异体移植物重建前交叉韧带：健康经济学视角。
Autograft or allograft for reconstruction of anterior cruciate ligament: a health economics perspective.
机构信息
Division of Health Sciences, Warwick Medical School, Gibbet Hill Campus, University of Warwick, Coventry, CV4 7AL, UK.
Warwick Clinical Trials Unit, University of Warwick Medical School, Coventry, CV4 7AL, UK.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2019 Jun;27(6):1782-1790. doi: 10.1007/s00167-019-05436-z. Epub 2019 Mar 14.
PURPOSE
To assess the clinical and cost-effectiveness of allografts versus autografts in the reconstruction of anterior cruciate ligaments.
METHODS
Systematic review of comparative clinical effectiveness and cost-effectiveness analysis.
RESULTS
Both autograft and allograft reconstruction are highly effective. Recent studies show little difference in failure rates between autografts and allografts (about 6% and 7%, respectively). In cost-effectiveness analysis, the price differential is the main factor, making autografts the first choice. However, there will be situations, particularly in revision ACL reconstruction, where an allograft may be preferred, or may be the only reasonable option available.
CONCLUSION
In ACL reconstruction, clinical results with autografts are as good as or slightly better than with allografts. Allografts cost more, indicating that autografts are more cost-effective and should usually be first choice.
LEVEL OF EVIDENCE
II.
目的
评估同种异体移植物与自体移植物在前交叉韧带重建中的临床和成本效益。
方法
对比较临床效果和成本效益分析进行系统评价。
结果
自体和同种异体重建均具有高度有效性。最近的研究表明，自体移植物和同种异体移植物的失败率差异很小（分别约为 6%和 7%）。在成本效益分析中，价格差异是主要因素，使自体移植物成为首选。然而，在某些情况下，特别是在 ACL 翻修重建中，可能更倾向于使用同种异体移植物，或者同种异体移植物可能是唯一合理的选择。
结论
在 ACL 重建中，自体移植物的临床效果与同种异体移植物一样好，甚至略好。同种异体移植物的成本更高，这表明自体移植物更具成本效益，通常应作为首选。
证据水平
II 级。
Zotero 插件