Quinn Matthew, Byrne Rory A, Albright J Alex, Testa Edward, Ahn Benjamin, Lemme Nicholas, Petit Logan, Blankenhorn Brad, Owens Brett D
Department of Orthopaedic Surgery, Alpert Medical School, Brown University, Providence, Rhode Island, U.S.A..
Department of Orthopaedic Surgery, Alpert Medical School, Brown University, Providence, Rhode Island, U.S.A.
Arthroscopy. 2024 Apr;40(4):1366-1376.e1. doi: 10.1016/j.arthro.2023.10.016. Epub 2023 Oct 26.
To examine the available literature to better understand the objective and patient-reported outcomes using peroneus longus tendon (PLT) autograft compared with more commonly used autografts, such as the quadrupled hamstring tendons (HT), in patients undergoing primary for anterior cruciate ligament reconstruction (ACLR).
A comprehensive search of published literature in PubMed, Web of Science, Cochrane Library, Ovid, and EMBASE databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria included patients undergoing ACLR with PLT autograft, inclusion of patient-recorded outcome measures, and availability in English language. Publications that included only biomechanical analysis or ACLR with use of allograft or combination grafts were excluded.
A total of 16 studies (Level of Evidence range: I-IV) met inclusion criteria, with follow-up ranging from 3 months to 5 years. In the available case series, patient-reported outcomes ranged from Lysholm = 80.7 to 95.1, International Knee Documentation Committee 78.1 to 95.7. In prospective cohorts and randomized controlled trials, PLT performance was comparable with HT autografts (PLT/HT: Lysholm = 88.3-95.1/86.5-94.9, International Knee Documentation Committee = 78.2-92.5/87.4-93.4). The majority of PLT grafts diameters were equal or greater than HT counterparts with a mean of >8 mm (PLT/HT: 7.0-9.0 mm/7.65-8.5 mm). There was minimal donor-site morbidity associated with PLT harvest.
Although limitations exist within the available literature, existing evidence suggests that PLT autograft routinely produces adequately sized grafts with comparable early outcomes to HT autograft and low risk of donor-site morbidity. However, the PLT autograft is yet to demonstrate superiority to any of the more-traditional autograft selections.
Level IV, systematic review of Level I-IV studies.
回顾现有文献，以更好地了解在初次前交叉韧带重建（ACLR）患者中，使用腓骨长肌腱（PLT）自体移植物与更常用的自体移植物（如四股腘绳肌腱（HT））相比的客观和患者报告结局。
根据系统评价和Meta分析的首选报告项目指南，对PubMed、Web of Science、Cochrane图书馆、Ovid和EMBASE数据库中的已发表文献进行全面检索。纳入标准包括接受PLT自体移植物ACLR的患者、纳入患者记录的结局指标以及英文文献。仅包括生物力学分析或使用同种异体移植物或联合移植物进行ACLR的出版物被排除。
共有16项研究（证据水平范围：I-IV）符合纳入标准，随访时间为3个月至5年。在现有病例系列中，患者报告的结局范围为Lysholm评分=80.7至95.1，国际膝关节文献委员会评分78.1至95.7。在前瞻性队列和随机对照试验中，PLT的表现与HT自体移植物相当（PLT/HT：Lysholm评分=88.3 - 95.1/86.5 - 94.9，国际膝关节文献委员会评分=78.2 - 92.5/87.4 - 93.4）。大多数PLT移植物的直径等于或大于HT移植物，平均>8 mm（PLT/HT：7.0 - 9.0 mm/7.65 - 8.5 mm）。PLT取材的供区并发症极少。
尽管现有文献存在局限性，但现有证据表明，PLT自体移植物通常能产生尺寸合适的移植物，早期结局与HT自体移植物相当，供区并发症风险低。然而，PLT自体移植物尚未证明优于任何更传统的自体移植物选择。
IV级，对I-IV级研究的系统评价。
