骨骼未成熟患者同种异体移植与自体移植前交叉韧带重建的系统评价
Allograft versus autograft ACL reconstruction in skeletally immature patients: a systematic review.
作者信息
Migliorini Filippo, Pilone Marco, Schäfer Luise, Bertini Francesca Alzira, Giorgino Riccardo, Maffulli Nicola
机构信息
Department of Life Sciences, Health, and Health Professions, Link Campus University, Via del Casale S. Pio V, 44, 00165 Rome, Italy.
Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Via Lorenz Böhler, 5, 39100 Bolzano, Italy.
出版信息
Br Med Bull. 2025 Jan 16;153(1). doi: 10.1093/bmb/ldae020.
INTRODUCTION
Anterior cruciate ligament (ACL) injuries in children and adolescents with open physes are common.
AREAS OF AGREEMENT
Evidence of ACL reconstruction using allografts in children with open physes is limited.
AREAS OF CONTROVERSY
Whether the outcomes of ACL allograft reconstruction in children and adolescents with open physes are superior to autograft ACL reconstruction is unclear, with contrasting evidence.
SOURCE OF DATA
In October 2024, the Web of Science, PubMed, and Embase were accessed with no additional filters. Only clinical investigations evaluating ACL reconstruction in children or adolescents with open physes were eligible. Only studies reporting a minimum length of 24 months of follow-up were included.
AREAS TIMELY FOR DEVELOPING RESEARCH
Children who undergo allograft ACL reconstruction demonstrate similar functional outcomes to those who undergo autograft ACL reconstruction. Although allografts allow a faster return to sport, the greater laxity, the reduced activity level, and the higher failure and reoperation rates make their use dubious as a first-choice option for ACL reconstruction in skeletally immature patients.
引言
在骨骺未闭的儿童和青少年中，前交叉韧带（ACL）损伤很常见。
共识领域
关于在骨骺未闭的儿童中使用同种异体移植物进行ACL重建的证据有限。
争议领域
对于骨骺未闭的儿童和青少年，同种异体移植物ACL重建的结果是否优于自体移植物ACL重建尚不清楚，证据相互矛盾。
数据来源
2024年10月，在没有额外筛选条件的情况下访问了科学网、PubMed和Embase。只有评估骨骺未闭的儿童或青少年ACL重建的临床研究符合条件。仅纳入报告了至少24个月随访期的研究。
适合开展研究的领域
接受同种异体移植物ACL重建的儿童与接受自体移植物ACL重建的儿童表现出相似的功能结果。尽管同种异体移植物能使患者更快恢复运动，但更大的松弛度、更低的活动水平以及更高的失败率和再次手术率，使其作为骨骼未成熟患者ACL重建的首选方案存在疑问。
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