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用于骨骼未成熟患者前交叉韧带重建的骨-髌腱-骨、腘绳肌和股四头肌肌腱自体移植物:一项系统评价

Bone-patellar tendon-bone, hamstring, and quadriceps tendon autografts for anterior cruciate ligament reconstruction in skeletally immature patients: a systematic review.

作者信息

Migliorini Filippo, Cocconi Federico, Schäfer Luise, Vaishya Raju, Kämmer Daniel, Maffulli Nicola

机构信息

Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical University, Via Lorenz Böhler 5, 39100, Bolzano, Italy.

Department of Life Sciences, Health, and Health Professions, Link Campus University, Via del Casale di San Pio V, 00165 Rome, Italy.

出版信息

Br Med Bull. 2024 Dec 12;152(1):16-27. doi: 10.1093/bmb/ldae011.

Abstract

INTRODUCTION

Historically, anterior cruciate ligament (ACL) ruptures in the paediatric age group were managed conservatively with bracing, casting, activity modification, and physical therapy. However, most of these patients had to reduce their sports activities, and secondary damages to the affected knee were prevalent.

SOURCE OF DATA

Published scientific literature in Embase, Web of Science, PubMed, and Google Scholar databases.

AREAS OF AGREEMENT

ACL reconstruction in children with open physes patients is debated. Any damage to the physes around the knee could lead to growth abnormalities and axial deviation of the knee.

AREAS OF CONTROVERSY

Different grafts are available and suitable for ACL reconstruction in skeletally immature patients; however, which graft performs better remains unclear.

GROWING POINTS

This systematic review compared bone-patellar tendon-bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT) autografts for ACL reconstruction in skeletally immature patients. The joint laxity, Patient-reported outcome measures (PROMs), return to sport, and complications were compared.

AREAS TIMELY FOR DEVELOPING RESEARCH

In skeletally immature patients, HT, BPTB, and QT autografts for ACL reconstruction yielded good outcomes. Comparative studies are strongly required to establish the most suitable autograft.

摘要

引言

从历史上看,小儿年龄组的前交叉韧带(ACL)断裂采用支具、石膏固定、调整活动和物理治疗等保守方法进行处理。然而,这些患者中的大多数不得不减少体育活动,并且患膝的继发性损伤很普遍。

数据来源

Embase、科学网、PubMed和谷歌学术数据库中已发表的科学文献。

共识领域

对于骨骺未闭合的儿童患者进行ACL重建存在争议。膝关节周围骨骺的任何损伤都可能导致生长异常和膝关节的轴向偏差。

争议领域

有不同的移植物可用于骨骼未成熟患者的ACL重建;然而,哪种移植物效果更好仍不清楚。

研究热点

本系统评价比较了骨-髌腱-骨(BPTB)、腘绳肌腱(HT)和股四头肌肌腱(QT)自体移植物用于骨骼未成熟患者的ACL重建。比较了关节松弛度、患者报告的结局指标(PROMs)、恢复运动情况和并发症。

亟待开展研究的领域

在骨骼未成熟患者中,HT、BPTB和QT自体移植物用于ACL重建均取得了良好的效果。迫切需要进行比较研究以确定最合适的自体移植物。

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