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股四头肌肌腱、髌腱骨移植和尸体移植物在前交叉韧带(ACL)修复与重建手术中的比较分析

A Comparative Analysis of Quadriceps Tendon, Patellar Tendon Bone Allograft, and Cadaver Graft in Anterior Cruciate Ligament (ACL) Repair and Reconstructive Surgery.

作者信息

Krumbach Brandon, Meretsky Christopher, Schiuma Anthony T, Ajebli Mohammed

机构信息

Anatomy, St. George's University, Great River, USA.

Medicine, St. George's University Medical School, True Blue, GRD.

出版信息

Cureus. 2024 May 7;16(5):e59836. doi: 10.7759/cureus.59836. eCollection 2024 May.

Abstract

Anterior cruciate ligament (ACL) injuries are a common occurrence among athletes and active individuals, often necessitating surgical intervention for optimal recovery. The choice of graft material for ACL reconstruction remains a topic of debate, with various options available, including quadriceps tendon (QT), patellar tendon bone allograft (PTBA), and cadaver graft (CG). This paper aims to provide an extensive review and comparison of the efficacy, outcomes, and complications associated with these graft types based on recent research. A systematic literature search following PRISMA guidelines was conducted to identify relevant studies published in the past six years. The findings suggest that while each graft type has its advantages and limitations, there is no definitive superior choice. Factors such as patient age, activity level, comorbidities, and surgeon preference should be considered when selecting the most appropriate graft for ACL repair surgery. QT grafts are associated with lower donor-site morbidity compared to patellar tendon grafts. However, QT grafts may have a higher risk of graft rupture and decreased knee flexion strength. PTBA grafts, compared to QT grafts, have a higher risk of donor-site morbidity but a lower risk of graft rupture and improved knee stability. CG grafts have lower donor-site morbidity compared to PTBA grafts but may have a higher risk of graft rupture and decreased knee flexion strength compared to PTBA grafts. In conclusion, the choice of graft material for ACL reconstruction is a complex decision that requires careful consideration of various factors, including patient age, activity level, comorbidities, and surgeon preference. While each graft type has its advantages and limitations, there is no definitive superior choice. Therefore, it is essential to carefully weigh the risks and benefits of each graft type to ensure optimal outcomes for patients undergoing ACL repair surgery.

摘要

前交叉韧带(ACL)损伤在运动员和活跃人群中很常见,通常需要手术干预以实现最佳恢复。ACL重建中移植物材料的选择仍然是一个有争议的话题,有多种选择,包括股四头肌肌腱(QT)、髌腱骨同种异体移植物(PTBA)和尸体移植物(CG)。本文旨在根据最近的研究,对这些移植物类型相关的疗效、结果和并发症进行广泛的综述和比较。按照PRISMA指南进行了系统的文献检索,以识别过去六年发表的相关研究。研究结果表明,虽然每种移植物类型都有其优点和局限性,但没有绝对 superior 的选择。在为ACL修复手术选择最合适的移植物时,应考虑患者年龄、活动水平、合并症和外科医生偏好等因素。与髌腱移植物相比,QT移植物的供体部位发病率较低。然而,QT移植物可能有更高的移植物破裂风险和膝关节屈曲力量下降。与QT移植物相比,PTBA移植物的供体部位发病率更高,但移植物破裂风险更低,膝关节稳定性更好。与PTBA移植物相比,CG移植物的供体部位发病率更低,但与PTBA移植物相比,可能有更高的移植物破裂风险和膝关节屈曲力量下降。总之,ACL重建移植物材料的选择是一个复杂的决定,需要仔细考虑各种因素,包括患者年龄、活动水平、合并症和外科医生偏好。虽然每种移植物类型都有其优点和局限性,但没有绝对 superior 的选择。因此,必须仔细权衡每种移植物类型的风险和益处,以确保接受ACL修复手术的患者获得最佳结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cfb/11156480/6f9bebe9d28a/cureus-0016-00000059836-i01.jpg

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