Akrivos Vasileios S, Gkekas Nifon, Chantes Ilias, Komnos George A, Koutalos Antonios A, Stefanou Nikolaos, Hantes Michael
Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, School of Health Sciences, University of Thessaly, Larissa, Greece.
Department of Applied Economics, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, PA Rotterdam, Netherlands.
Sports Med Arthrosc Rev. 2025 Sep 1;33(3):93-104. doi: 10.1097/JSA.0000000000000429. Epub 2025 Mar 10.
Comprehensive studies on the exclusive use of allografts for medial collateral ligament (MCL) and posterolateral corner (PLC) reconstruction are limited. This review assessed clinical and functional outcomes of allograft use for MCL and PLC reconstruction. The PRISMA guidelines were followed. A systematic search of the literature was performed in PubMed, MEDLINE, Web of Science, Cochrane (CENTRAL), and Scopus databases to identify published articles on clinical studies relevant to MCL and LCL reconstruction with the use of allografts. The results of the eligible studies were analyzed in terms of stability and functional outcomes, Lysholm score, objective and subjective International Knee Documentation Committee (IKDC) scores, Tegner activity scale, Cincinnati Knee Rating System, Marx score, complications, and graft failure. Nineteen studies with 547 patients undergoing LCL reconstructions using allografts were analyzed. The most common allograft used was the Achilles tendon. Mean lateral opening improved from 6.21 mm preoperatively to 1.88 mm postoperatively, with IKDC and Lysholm scores increasing significantly (44.02 to 74.78 and 53.44 to 85.68, respectively). The failure rate for LCL/PLC reconstructions was 11.13%, and complications occurred in 19.75%. For MCL reconstructions, 5 studies with 135 patients showed a reduction in medial opening from 9.7 mm to 2.33 mm, with increases in IKDC and Lysholm scores (49.8 to 75.92 and 69.3 to 85.46, respectively). The failure rate was 4.19%, with a 10.93% complication rate. The use of allografts for LCL and PLC reconstruction demonstrated satisfactory outcomes, with stable and functional knees, though there was a relatively high graft failure rate. Similarly, positive results were observed in MCL reconstruction with allografts. Level of Evidence: Level-IV.
关于单纯使用同种异体移植物进行内侧副韧带（MCL）和后外侧角（PLC）重建的综合研究有限。本综述评估了使用同种异体移植物进行MCL和PLC重建的临床和功能结果。遵循PRISMA指南。在PubMed、MEDLINE、科学网、Cochrane（CENTRAL）和Scopus数据库中对文献进行系统检索，以识别已发表的关于使用同种异体移植物进行MCL和外侧副韧带（LCL）重建的临床研究文章。对符合条件的研究结果从稳定性和功能结果、Lysholm评分、客观和主观的国际膝关节文献委员会（IKDC）评分、Tegner活动量表、辛辛那提膝关节评分系统、Marx评分、并发症和移植物失败情况进行分析。分析了19项研究，共547例患者使用同种异体移植物进行LCL重建。最常用的同种异体移植物是跟腱。平均外侧开口术前为6.21mm，术后改善至1.88mm，IKDC和Lysholm评分显著提高（分别从44.02提高到74.78和从53.44提高到85.68）。LCL/PLC重建的失败率为11.13%，并发症发生率为19.75%。对于MCL重建，5项研究共135例患者显示内侧开口从9.7mm降至2.33mm，IKDC和Lysholm评分提高（分别从49.8提高到75.92和从69.3提高到85.46）。失败率为4.19%，并发症发生率为10.93%。使用同种异体移植物进行LCL和PLC重建显示出令人满意的结果，膝关节稳定且功能良好，尽管移植物失败率相对较高。同样，使用同种异体移植物进行MCL重建也观察到了积极结果。证据级别：四级。
