Vivekanantha Prushoth, Kahlon Harjind, Hassan Zackariyah, Slawaska-Eng David, Abdel-Khalik Hassaan, Johnson Jansen, de Sa Darren
Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Knee Surg Sports Traumatol Arthrosc. 2025 Feb;33(2):413-427. doi: 10.1002/ksa.12366. Epub 2024 Jul 17.
To evaluate the clinical outcomes in patients undergoing revision anterior cruciate ligament reconstruction (r-ACLR) using hamstring tendon (HT) autografts with those using either quadriceps tendon (QT) or bone-patellar tendon-bone (BPTB) autografts or allografts.
Three databases were searched on 8 August 2023. The authors adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Data on demographics, surgical details, patient-reported outcome measures (PROMs), rates of instability, failure and return to sport (RTS) were extracted.
Eleven studies comprising 859 patients were included in this review. Five studies compared HT and QT autografts. One study each reported greater IKDC scores (p = 0.04) and Tegner scores (p = 0.04) in the QT group, while one study each reported higher anterior translation (p = 0.04), rates of positive pivot shift (p = 0.03) and rates of failure (p = 0.03) in the HT group. Six studies compared HT and BPTB autografts with one study each reporting greater Lysholm scores (p = 0.02) and less side-to-side anterior laxity (p < 0.01) in the BPTB group. Two studies compared HT autografts with allografts with only one study reporting a faster time to RTS in the HT group than the allograft group (p < 0.001). All other comparisons were not significant.
HT autografts result in either similar or inferior outcomes in r-ACLR when compared to QT or BPTB autograft options. Allografts resulted in similar outcomes to HT autografts apart from greater time to RTS for r-ACLR.
Level III.
评估使用腘绳肌腱（HT）自体移植物进行前交叉韧带翻修重建（r-ACLR）的患者与使用股四头肌肌腱（QT）、髌腱-骨（BPTB）自体移植物或同种异体移植物的患者的临床结局。
于2023年8月8日检索了三个数据库。作者遵循系统评价和Meta分析的首选报告项目（PRISMA）、修订的多个系统评价评估（R-AMSTAR）指南以及干预措施系统评价的Cochrane手册。提取了人口统计学、手术细节、患者报告结局指标（PROMs）、不稳定率、失败率和恢复运动（RTS）率的数据。
本综述纳入了11项研究，共859例患者。5项研究比较了HT和QT自体移植物。一项研究报告QT组的国际膝关节文献委员会（IKDC）评分更高（p = 0.04），一项研究报告QT组的Tegner评分更高（p = 0.04），而一项研究报告HT组的前向平移更高（p = 0.04）、阳性轴移率更高（p = 0.03）和失败率更高（p = 0.03）。6项研究比较了HT和BPTB自体移植物，一项研究报告BPTB组的Lysholm评分更高（p = 0.02），一项研究报告BPTB组的左右侧前向松弛度更小（p < 0.01）。2项研究比较了HT自体移植物和同种异体移植物，只有一项研究报告HT组恢复运动的时间比同种异体移植物组更快（p < 0.001）。所有其他比较均无统计学意义。
与QT或BPTB自体移植物相比，HT自体移植物在r-ACLR中的结局相似或较差。除了r-ACLR恢复运动的时间更长外，同种异体移植物与HT自体移植物的结局相似。
三级。
