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同种异体移植物与半腱肌自体移植物用于翻修前交叉韧带重建治疗效果的比较评估

Comparative Evaluation of Treatment Outcomes of Revision Anterior Cruciate Ligament Reconstruction Using Allograft and Semitendinosus Autograft.

作者信息

Kentel Maciej, Kentel Monika, Korolczuk Krzysztof, Witkowski Jarosław

机构信息

eMKaMED Medical Center, 53-110 Wroclaw, Poland.

Department of Orthopedics, Traumatology and Hand Surgery, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland.

出版信息

J Clin Med. 2024 Dec 29;14(1):133. doi: 10.3390/jcm14010133.

Abstract

The number of revision anterior cruciate ligament reconstruction (RACLR) procedures is increasing in proportion to the increase in the number of anterior cruciate ligament reconstruction (ACLR) procedures. Although approximately 50-75% of these procedures can be performed in a single-stage procedure, not all of them can. The choice of graft may influence the results of RACLR. The most commonly mentioned graft materials for RACLR are allografts and autografts. : The aim of the study was to evaluate the results of single-stage RACLR using a semitendinosus (ST) autograft or allograft and to follow-up and compare the results of both groups after 2 years. : The retrospective cohort study was carried out between 2008 and 2021, during which time 2327 ACLRs were performed. Graft rupture occurred in 198 (8.5%) patients, and 98 (4.2%) patients underwent RACLR. RACLR was performed as a single-stage procedure using a semitendinosus autograft or allograft in 56 patients. The KT-2000, Lachman and axis shift, range of motion, Tegner, Lysholm, KSS, KOOS, and IKDC tests were used to assess outcomes. : There were no differences between the groups in terms of age, time of revision after procedure, parameters for the graft (screw diameter, endobutton length, femoral tunnel length) or for the procedure and revision, BMI, or in the time needed for returning to dynamics and training. The groups did not differ in quality of life in any measurements, stiffness, pain function, or sport. Analysis showed higher Lysholm results on the day of treatment in the autograft group than in the allograft group ( = 0.11). The allograft group had higher KSS scores on the day of treatment ( = 0.11) and after 60 months or at the moment of breakup than the autograft group ( = 0.025). : Single-stage revision anterior cruciate ligament reconstruction with an autograft and ST provides good knee stability. The results of single-stage revision anterior cruciate ligament treatment using an ST autograft or an ST allograft are similar.

摘要

翻修前交叉韧带重建(RACLR)手术的数量随着前交叉韧带重建(ACLR)手术数量的增加而增加。尽管这些手术中约50-75%可以在一期手术中完成,但并非全部如此。移植物的选择可能会影响RACLR的结果。RACLR中最常提及的移植物材料是同种异体移植物和自体移植物。本研究的目的是评估使用半腱肌(ST)自体移植物或同种异体移植物进行一期RACLR的结果,并对两组在2年后的结果进行随访和比较。这项回顾性队列研究在2008年至2021年期间进行,在此期间共进行了2327例ACLR手术。198例(8.5%)患者发生移植物破裂,98例(4.2%)患者接受了RACLR。56例患者使用半腱肌自体移植物或同种异体移植物进行了一期RACLR手术。使用KT-2000、Lachman和轴移试验、活动范围、Tegner、Lysholm、KSS、KOOS和IKDC试验来评估结果。两组在年龄、手术后翻修时间、移植物参数(螺钉直径、纽扣长度、股骨隧道长度)或手术及翻修参数、BMI,以及恢复运动和训练所需时间方面均无差异。两组在任何测量的生活质量、僵硬程度、疼痛功能或运动方面均无差异。分析显示,自体移植物组在治疗当天的Lysholm结果高于同种异体移植物组(=0.11)。同种异体移植物组在治疗当天(=0.11)以及60个月后或随访结束时的KSS评分高于自体移植物组(=0.025)。使用自体移植物和ST进行一期翻修前交叉韧带重建可提供良好的膝关节稳定性。使用ST自体移植物或ST同种异体移植物进行一期翻修前交叉韧带治疗的结果相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af88/11720847/c1f26ac95442/jcm-14-00133-g001.jpg

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