Practice LEONARDO, Hirslanden Clinic Birshof, Münchenstein, Switzerland.
Department of Orthopaedic Surgery, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA.
Knee Surg Sports Traumatol Arthrosc. 2021 Nov;29(11):3871-3876. doi: 10.1007/s00167-021-06443-9. Epub 2021 Jan 24.
Anterior cruciate ligament reconstruction (ACLR) aims to restore knee function and stability, allowing patients to return to the activities they enjoy and minimize further injury to the meniscus and cartilage and their ultimate progression to osteoarthritis. This study aims to present the evolution of graft choice over the last three decades according to members of the ACL Study Group (SG).
Prior to the January 2020 ACL SG biannual meeting, a survey was administered consisting of 87 questions and 16 categories, including ACLR graft choice. A similar questionnaire has been administered prior to each meeting and survey results from the past 14 meetings (1992 through 2020, excluding 1994) are included in this work. Survey responses are reported as frequencies in percentages to quantify changes in practice over the surgery period.
In 1992, the most frequent graft choice for primary ACLR was bone-patellar tendon-bone (BTB) autograft, at nearly 90%. Hamstring tendon (HT) autografts have increased in popularity, currently over 50%, followed by just under 40% BTB autograft. Recently, quadriceps tendon (QT) autograft has increased in popularity since 2014.
Autograft (HT, BTB, QT) is an overwhelming favorite for primary ACLR over allograft. The preference for HT autograft increased over the study period relative to BTB autograft, with QT autograft gaining in popularity in recent years. Graft selection should be individualized for each patient and understanding the global trends in graft choice can help orthopaedic surgeons discuss graft options with their patients and determine the appropriate graft for each case.
Level V, Expert Opinion.
前交叉韧带重建（ACLR）旨在恢复膝关节功能和稳定性，使患者能够恢复他们喜爱的活动，并最大程度地减少半月板和软骨的进一步损伤及其最终进展为骨关节炎。本研究旨在根据 ACL 研究小组（SG）成员介绍过去三十年中移植物选择的演变。
在 2020 年 1 月 ACL SG 半年会议之前，进行了一项调查，其中包含 87 个问题和 16 个类别，包括 ACLR 移植物选择。在每次会议之前都进行了类似的问卷调查，并且包括过去 14 次会议（1992 年至 2020 年，不包括 1994 年）的调查结果。调查结果以百分比的频率报告，以量化手术期间实践的变化。
1992 年，初次 ACLR 最常见的移植物选择是骨-髌腱-骨（BTB）自体移植物，接近 90%。自体腘绳肌腱（HT）移植物的受欢迎程度增加，目前超过 50%，其次是接近 40%的 BTB 自体移植物。最近，自 2014 年以来，四头肌腱（QT）自体移植物的受欢迎程度有所增加。
自体移植物（HT、BTB、QT）是初次 ACLR 相对于同种异体移植物的首选。与 BTB 自体移植物相比，在研究期间，HT 自体移植物的偏好增加，近年来 QT 自体移植物的受欢迎程度增加。移植物选择应根据每个患者的个体情况进行个性化选择，了解移植物选择的全球趋势可以帮助骨科医生与患者讨论移植物选择，并为每个病例确定合适的移植物。
五级，专家意见。
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