Beijing University of Chinese Medicine, Beijing, China.
Department of Joint Surgery and Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, No 6, South Zhonghuan Road, Chaoyang District, Beijing, 100102, People's Republic of China.
J Orthop Surg Res. 2021 Aug 4;16(1):478. doi: 10.1186/s13018-021-02624-x.
The aim of anterior cruciate ligament reconstruction (ACLR) is to restore the function of the knee joint, protect the cartilage, and reduce the occurrence of osteoarthritis. However, due to the structural limitations of the human body, it is not possible to perform ACLR with conventional sutures. To restore normal functioning of the anterior cruciate ligament (ACL), a new ligament must be reconstructed in the position of the previous ACL.
To compare autografts and synthetic grafts in terms of postoperative knee stability and function SEARCH METHODS: The protocol for this study was registered with PROSPERO (CRD42021243451). Two reviewers independently searched the PubMed, Embase, and the Cochrane Library databases from database inception though February 10, 2021. The following search method was used: ((Autograft) OR (Autologous) OR (Autotransplant)) OR Artificial Ligament AND (Anterior Cruciate Ligament Injury [MeSH Terms]) AND (Randomized controlled trial [MeSH Terms]). Methodological quality was assessed by the Cochrane risk of bias tool.
We only included randomized controlled trials (level I) that compared autograft and synthetic graft interventions in participants with ACL injury. We included trials that evaluated ACLR using at least one outcome (Lachman test, pivot shift test, IKDC grades, or complications).
A total of 748 studies were identified in the initial literature search, and seven studies that examined only bone-patellar tendon-bone (BPTB) grafts compared with artificial grafts met the predetermined inclusion criteria. The results showed that BPTB grafts were associated with significantly better pivot shift test and Lachman test results and better IKDC grades and lower complication rates than synthetic grafts.
This review indicates that for adults, BPTB grafts perform more favorably than synthetic grafts in ACLR in terms of knee stability, function, and complication. More research is needed to compare autologous tendons and allogeneic tendons with artificial ligaments, especially in elderly individuals.
Level I, systematic review and meta-analysis.
前交叉韧带重建（ACLR）的目的是恢复膝关节功能，保护软骨，降低骨关节炎的发生。然而，由于人体结构的限制，用传统缝线进行 ACLR 是不可能的。为了恢复前交叉韧带（ACL）的正常功能，必须在前 ACL 的位置重建新的韧带。
比较自体移植物和合成移植物在术后膝关节稳定性和功能方面的差异。
本研究的方案在 PROSPERO（CRD42021243451）中进行了注册。两位审查员独立检索了 PubMed、Embase 和 Cochrane 图书馆数据库，检索时间从数据库建立到 2021 年 2 月 10 日。使用的搜索方法如下：((自体移植物)或(自体)或(自体移植))或人工韧带和(前交叉韧带损伤[MeSH 主题])和(随机对照试验[MeSH 主题])。使用 Cochrane 偏倚风险工具评估方法学质量。
我们仅纳入了比较 ACL 损伤患者自体移植物和合成移植物干预的随机对照试验（I 级）。我们纳入了使用至少一种结果（Lachman 试验、枢轴转移试验、IKDC 分级或并发症）评估 ACLR 的试验。
最初的文献检索共确定了 748 项研究，仅有 7 项研究仅检查了骨-髌腱-骨（BPTB）移植物与人工移植物的比较，符合预定的纳入标准。结果表明，BPTB 移植物在枢轴转移试验和 Lachman 试验结果、IKDC 分级和较低的并发症发生率方面明显优于合成移植物。
本综述表明，对于成年人，BPTB 移植物在前交叉韧带重建中在膝关节稳定性、功能和并发症方面的表现优于合成移植物。需要更多的研究来比较自体肌腱和同种异体肌腱与人工韧带，特别是在老年人中。
I 级，系统评价和荟萃分析。
