腘绳肌自体移植与胫骨异体移植在残余张力前交叉韧带重建术后的临床、影像学及二次关节镜检查结果比较

Comparison of clinical, radiological, and second-look arthroscopic outcomes between hamstring autograft and tibialis allograft following remnant-tensioning anterior cruciate ligament reconstruction.

作者信息

Lee Sung-Sahn, Choi Young Jin, Oh Juyong, Ryu Dong Jin, Wang Joon Ho

机构信息

Department of Orthopedic Surgery, Ilsan Paik Hospital, Inje University School of Medicine, Goyangsi, Gyeonggido, Korea.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea.

出版信息

Arch Orthop Trauma Surg. 2025 May 20;145(1):303. doi: 10.1007/s00402-025-05919-4.

Abstract

BACKGROUND

The remnant-tensioning (RT) anterior cruciate ligament reconstruction (ACLR) has been reported to have excellent postoperative outcomes. However, the influence of graft selection on postoperative outcomes of autografts and allografts after RT-ACLR has been poorly investigated. The purpose of our study was to compare the clinical, radiological, and second-look arthroscopic outcomes of autografts and allografts following RT-ACLR.

METHODS

Between January 2013 and May 2020, 94 and 64 patients were enrolled in auto (hamstring tendon) and allo (tibialis tendon) groups, respectively. For subgroup analysis, patients were divided into two age categories: ≤34 and > 34 years of age. Stability tests, including the Lachman and Pivot shift tests, side-to-side differences on Telos stress radiographs and KT-2000 arthrometer, patient-reported outcome measurements (PROMs), and graft status on postoperative magnetic resonance imaging (MRI) and second-look arthroscopy, were evaluated and compared between the two groups.

RESULTS

The two groups showed no statistically significant differences in stability outcomes or PROMs for patients aged ≤ 34 and > 34 years. Furthermore, both groups demonstrated comparable postoperative graft status on postoperative MRI and second-look arthroscopy analyses in patients aged ≤ 34 and > 34 years.

CONCLUSION

RT-ACLR using allografts yielded similar postoperative clinical outcomes, MRI findings, and second-look results compared to autografts, irrespective of patients' age. Therefore, allografts may serve as a viable option for patients scheduled for RT-ACLR.

摘要

背景

据报道,残端张力前交叉韧带重建术(RT-ACLR)术后效果极佳。然而,关于移植物选择对RT-ACLR术后自体移植物和异体移植物效果的影响,相关研究较少。我们研究的目的是比较RT-ACLR术后自体移植物和异体移植物的临床、影像学及二次关节镜检查结果。

方法

2013年1月至2020年5月期间,分别有94例和64例患者纳入自体(腘绳肌腱)组和异体(胫前肌腱)组。为进行亚组分析,将患者分为两个年龄类别:≤34岁和>34岁。评估并比较两组的稳定性测试,包括Lachman试验和轴移试验、Telos应力X线片和KT-2000关节测量仪的双侧差异、患者报告的结局测量(PROMs),以及术后磁共振成像(MRI)和二次关节镜检查的移植物状态。

结果

在≤34岁和>34岁的患者中,两组在稳定性结果或PROMs方面无统计学显著差异。此外,在≤34岁和>34岁的患者中,两组在术后MRI和二次关节镜检查分析中的术后移植物状态相当。

结论

无论患者年龄如何,与自体移植物相比,使用异体移植物的RT-ACLR术后临床结果、MRI表现和二次检查结果相似。因此,对于计划进行RT-ACLR的患者,异体移植物可能是一种可行的选择。

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