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前交叉韧带重建中骨-髌腱-骨自体移植：一种综合方法

Bone-Patellar Tendon-Bone Autograft in Anterior Cruciate Ligament Reconstruction: A Comprehensive Approach.

作者信息

Jaber Ayham, Murphy Colin, Hawryluk Christopher J, Arbili Lana, Hinz Maximilian, Cortes Natalie, Millett Peter J

机构信息

Steadman Philippon Research Institute, Vail, Colorado, U.S.A.

Department of Orthopedic surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.

出版信息

Arthrosc Tech. 2025 May 17;14(7):103629. doi: 10.1016/j.eats.2025.103629. eCollection 2025 Jul.

DOI:10.1016/j.eats.2025.103629
PMID:40822211
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12350212/
Abstract

Anterior cruciate ligament reconstruction using a bone-patellar tendon-bone autograft is widely regarded as the graft of choice for many sports medicine surgeons for young, active patients with anterior cruciate ligament injuries. It is favored for use in athletes because of its high return-to-play rates and low re-rupture rates. Despite its benefits, there are many pitfalls in the surgical technique, and the use of a careful surgical technique can avoid them. This article describes our preferred technique.

摘要

对于年轻、活跃的前交叉韧带损伤患者，使用自体骨-髌腱-骨移植进行前交叉韧带重建被许多运动医学外科医生广泛视为首选移植物。由于其高重返比赛率和低再破裂率，它在运动员中很受青睐。尽管有这些优点，但手术技术存在许多陷阱，采用谨慎的手术技术可以避免这些问题。本文介绍了我们首选的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/63e676c8870b/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/df26bfe2614d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/b586197890af/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/c4481c591e66/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/0f69b3305360/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/14a804b34aa4/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/328c1b077c0d/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/3f853dbf84a8/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/63e676c8870b/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/df26bfe2614d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/b586197890af/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/c4481c591e66/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/0f69b3305360/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/14a804b34aa4/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/328c1b077c0d/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/3f853dbf84a8/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f07/12350212/63e676c8870b/gr8.jpg

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2
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本文引用的文献

1
Primary Anterior Cruciate Ligament Reconstruction Performed With Hamstring Tendon Autograft Leads to an Over 4 Times Greater Rate of Second Anterior Cruciate Ligament Rupture After Return to Sport in Patients With Generalized Joint Hypermobility Compared With Bone-Patellar Tendon-Bone Autograft.与采用骨-髌腱-骨自体移植物相比，采用腘绳肌腱自体移植物进行初次前交叉韧带重建后，全身关节过度活动的患者恢复运动后第二次前交叉韧带断裂的发生率高出4倍多。
Arthroscopy. 2025 Sep;41(9):3336-3345.e1. doi: 10.1016/j.arthro.2025.01.028. Epub 2025 Jan 30.
2
Editorial Commentary: Quadrupled Semitendinosus Autograft Is a Suitable Graft Choice for Anterior Cruciate Reconstruction, Regardless of Diameter, in Patients With Lower Risk for Rerupture.编辑评论：对于再破裂风险较低的患者，无论直径如何，四倍半腱肌自体移植物都是前交叉韧带重建的合适移植物选择。
Arthroscopy. 2025 Feb;41(2):246-247. doi: 10.1016/j.arthro.2024.09.031. Epub 2024 Sep 24.
3
Bone-patellar tendon-bone autograft is associated with a higher rate of return to preinjury levels of performance in high-level athletes than anterior cruciate ligament reconstruction using hamstring autograft.与使用腘绳肌自体移植进行前交叉韧带重建相比，骨-髌腱-骨自体移植在高水平运动员中恢复到伤前运动水平的比例更高。
Knee Surg Sports Traumatol Arthrosc. 2024 Jun;32(6):1384-1395. doi: 10.1002/ksa.12144. Epub 2024 Apr 1.
4
Both Quadriceps and Bone-Patellar Tendon-Bone Autografts Improve Postoperative Stability and Functional Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review.股四头肌和髌腱-骨自体移植物均能改善前交叉韧带重建术后的稳定性和功能结果：一项系统评价。
Arthrosc Sports Med Rehabil. 2024 Mar 9;6(2):100919. doi: 10.1016/j.asmr.2024.100919. eCollection 2024 Apr.
5
Functional Return-to-Sport Testing Demonstrates Inconsistency in Predicting Short-Term Outcomes Following Anterior Cruciate Ligament Reconstruction: A Systematic Review.功能性重返运动测试在前交叉韧带重建后预测短期结果方面存在不一致性：系统评价。
Arthroscopy. 2024 Jul;40(7):2135-2151.e2. doi: 10.1016/j.arthro.2023.12.032. Epub 2024 Jan 11.
6
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Arthrosc Sports Med Rehabil. 2023 Jul 20;5(4):100766. doi: 10.1016/j.asmr.2023.100766. eCollection 2023 Aug.
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The "N+10 Rule" to Avoid Graft-Tunnel Mismatch in Bone-Patellar Tendon-Bone ACL Reconstruction Using Independent Femoral Tunnel Drilling.在采用独立股骨隧道钻孔的骨-髌腱-骨前交叉韧带重建中避免移植物-隧道不匹配的“N + 10规则”
Orthop J Sports Med. 2023 May 23;11(5):23259671231168885. doi: 10.1177/23259671231168885. eCollection 2023 May.
8
Quadriceps tendon autograft is comparable to hamstring tendon and bone-patella-tendon-bone up to 2 years after isolated primary anterior cruciate ligament reconstruction.在单独进行初次前交叉韧带重建术后 2 年内，股四头肌腱自体移植物的效果可与腘绳肌腱和骨-髌腱-骨相媲美。
Knee Surg Sports Traumatol Arthrosc. 2023 Aug;31(8):3268-3276. doi: 10.1007/s00167-023-07370-7. Epub 2023 Mar 9.
9
Bone filling decreases donor site morbidity after anterior cruciate ligament reconstruction with bone-patellar tendon-bone autografts.骨填充可降低自体骨-髌腱-骨重建前交叉韧带后供区的发病率。
Arch Orthop Trauma Surg. 2023 May;143(5):2565-2572. doi: 10.1007/s00402-022-04572-5. Epub 2022 Aug 2.
10
An update on graft-tunnel mismatch in anterior cruciate ligament reconstruction: A survey of the experts in the field of orthopedic sports medicine demonstrates no clear consensus in management.前交叉韧带重建中移植物-隧道不匹配的最新进展：一项针对骨科运动医学领域专家的调查表明，在管理方面尚无明确共识。
Knee. 2020 Oct;27(5):1525-1533. doi: 10.1016/j.knee.2020.08.003. Epub 2020 Aug 27.