Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Centro per la ricostruzione articolare del ginocchio, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy.
Knee Surg Sports Traumatol Arthrosc. 2024 May;32(5):1123-1142. doi: 10.1002/ksa.12113. Epub 2024 Mar 15.
Surgeons generally consider the donor age as a factor that negatively influences the quality of allograft used in anterior cruciate ligament (ACL) reconstruction, however, the available evidence does not clearly support this statement. The purpose of the study was to investigate if donor age influences the biomechanical properties of allografts used in ACL reconstruction.
A comprehensive literature search was conducted for all relevant articles using MEDLINE (PubMed), Scopus, and Cochrane Collaboration Library, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Studies including the analysis of the correlation between biomechanical properties of the allografts and donor age were selected. The role of donor age was labelled as 'none' if absent, 'higher' or 'lower' if the properties were higher or lower in older specimens with respect to younger. The correlation was defined as 'weak' or 'strong' according to each study definition.
No conflicting role of donor age was reported for modulus of elasticity, load to failure, strain, stiffness and displacement. The only parameters where the significant results were consistent were the tensile strength and the stress (low or moderate correlations). When considering the tested samples with a donor's age <65 years, a significant role of age was reported in only four out of 13 groups of graft tested (patellar tendon, fascia lata, anterior tibialis tendon and posterior tibialis tendon).
The current literature did not allow to state that the donor age negatively influences the biomechanical properties of allografts, making it impossible to identify a clear age cut-off value to exclude them from ACL reconstruction procedures.
Level IV, systematic review.
外科医生普遍认为供体年龄是影响前交叉韧带（ACL）重建中同种异体移植物质量的一个因素，但现有证据并不明确支持这一说法。本研究旨在探讨供体年龄是否会影响 ACL 重建中使用的同种异体移植物的生物力学特性。
根据系统评价和荟萃分析的首选报告项目，使用 MEDLINE（PubMed）、Scopus 和 Cochrane 协作图书馆对所有相关文章进行了全面的文献检索。选择分析同种异体移植物生物力学特性与供体年龄之间相关性的研究。如果不存在相关性，则将供体年龄的作用标记为“无”；如果与年轻供体相比，老年供体的特性更高或更低，则标记为“更高”或“更低”。根据每项研究的定义，将相关性定义为“弱”或“强”。
未报告供体年龄对弹性模量、破坏载荷、应变、刚度和位移有冲突的作用。仅在拉伸强度和应力（低或中度相关性）方面，有显著结果的参数是一致的。当考虑供体年龄<65 岁的测试样本时，在 13 组测试移植物中（髌腱、阔筋膜、胫骨前肌腱和胫骨后肌腱），只有 4 组报告了年龄的显著作用。
目前的文献还不能说明供体年龄会对同种异体移植物的生物力学特性产生负面影响，因此无法确定一个明确的年龄截止值来排除它们用于 ACL 重建手术。
IV 级，系统评价。
