DeFazio Matthew W, Curry Emily J, Gustin Michael J, Sing David C, Abdul-Rassoul Hussein, Ma Richard, Fu Freddie, Li Xinning
Department of Orthopaedic Surgery, Boston University School of Medicine, Boston, Massachusetts, USA.
Boston University School of Public Health, Boston, Massachusetts, USA.
Orthop J Sports Med. 2020 Dec 15;8(12):2325967120964919. doi: 10.1177/2325967120964919. eCollection 2020 Dec.
Anterior cruciate ligament (ACL) tears are debilitating injuries frequently suffered by athletes. ACL reconstruction is indicated to restore knee stability and allow patients to return to prior levels of athletic performance. While existing literature suggests that patient-reported outcomes are similar between bone-patellar tendon-bone (BTB) and hamstring tendon (HT) autografts, there is less information comparing return-to-sport (RTS) rates between the 2 graft types.
To compare RTS rates among athletes undergoing primary ACL reconstruction using a BTB versus HT autograft.
Systematic review; Level of evidence, 4.
The MEDLINE, Embase, and Cochrane Library databases were searched, and studies that reported on RTS after primary ACL reconstruction using a BTB or HT autograft were included. Studies that utilized ACL repair techniques, quadriceps tendon autografts, graft augmentation, double-bundle autografts, allografts, or revision ACL reconstruction were excluded. RTS information was extracted and analyzed from all included studies.
Included in the review were 20 articles investigating a total of 2348 athletes. The overall RTS rate in our cohort was 73.2%, with 48.9% returning to preinjury levels of performance and a rerupture rate of 2.4%. The overall RTS rate in patients after primary ACL reconstruction with a BTB autograft was 81.0%, with 50.0% of athletes returning to preinjury levels of performance and a rerupture rate of 2.2%. Patients after primary ACL reconstruction with an HT autograft had an overall RTS rate of 70.6%, with 48.5% of athletes returning to preinjury levels of performance and a rerupture rate of 2.5%.
ACL reconstruction using BTB autografts demonstrated higher overall RTS rates when compared with HT autografts. However, BTB and HT autografts had similar rates of return to preinjury levels of performance and rerupture rates. Less than half of the athletes were able to return to preinjury sport levels after ACL reconstruction with either an HT or BTB autograft.
前交叉韧带（ACL）撕裂是运动员常遭受的致残性损伤。ACL重建旨在恢复膝关节稳定性，使患者恢复到受伤前的运动表现水平。虽然现有文献表明，患者报告的骨-髌腱-骨（BTB）和腘绳肌腱（HT）自体移植的结果相似，但比较这两种移植类型的重返运动（RTS）率的信息较少。
比较接受初次ACL重建的运动员使用BTB与HT自体移植后的RTS率。
系统评价；证据等级，4级。
检索MEDLINE、Embase和Cochrane图书馆数据库，纳入报道初次ACL重建使用BTB或HT自体移植后RTS情况的研究。排除采用ACL修复技术、股四头肌肌腱自体移植、移植增强、双束自体移植、异体移植或ACL翻修重建的研究。从所有纳入研究中提取并分析RTS信息。
纳入本综述的有20篇文章，共调查了2348名运动员。我们队列中的总体RTS率为73.2%，48.9%的运动员恢复到受伤前的表现水平，再破裂率为2.4%。初次ACL重建采用BTB自体移植的患者总体RTS率为81.0%，50.0%的运动员恢复到受伤前的表现水平，再破裂率为2.2%。初次ACL重建采用HT自体移植的患者总体RTS率为70.6%，48.5%的运动员恢复到受伤前的表现水平，再破裂率为2.5%。
与HT自体移植相比，使用BTB自体移植进行ACL重建的总体RTS率更高。然而，BTB和HT自体移植恢复到受伤前表现水平的比率和再破裂率相似。使用HT或BTB自体移植进行ACL重建后，不到一半的运动员能够恢复到受伤前的运动水平。
