Marks P H, Cameron M, Fu F H
Orthopaedic and Arthritic Hospital, University of Toronto, Ontario, Canada.
Orthopade. 1993 Nov;22(6):386-91.
The authors have used allografts for reconstruction of the cruciate ligaments in over 600 cases since 1985. Advantages are the reduced operative trauma and the unlimited availability of high-quality grafts even in multiple ligament reconstructions. Arthroscopic techniques are available for reconstruction of the anterior and the posterior cruciate ligament, which makes arthrotomies and large skin incisions unnecessary. The grafts of choice are the bone-patellar tendon-bone preparation and the Achilles tendon with bone bloc. No specific complications were observed with the use of allograft material in this series. Results show a high subjective acceptance of the procedure among the patients, with a high rate of return to pre-injury sports activities following ACL reconstruction. Objective stability was restored in over 70% of these cases. All cases with posterior instability had 3+ posterior drawer preoperatively. At follow-up, almost normal stability had been restored in 50%. Further research must focus on the biological processes that take place during incorporation of these tissues and on better techniques of graft processing and sterilisation. At present, the risk of disease transmission must be considered and discussed with the patient.
自1985年以来，作者已使用同种异体移植物重建交叉韧带超过600例。其优点是手术创伤减小，即使在进行多条韧带重建时也能获得无限量的高质量移植物。关节镜技术可用于重建前交叉韧带和后交叉韧带，从而无需进行关节切开术和大的皮肤切口。首选的移植物是骨-髌腱-骨移植物和带骨块的跟腱。在本系列中，使用同种异体移植物材料未观察到特定并发症。结果显示患者对该手术的主观接受度较高，前交叉韧带重建术后恢复到伤前体育活动水平的比例较高。超过70%的此类病例恢复了客观稳定性。所有后交叉韧带不稳定的病例术前均有3度以上后抽屉试验阳性。随访时，50%的病例恢复了几乎正常的稳定性。进一步的研究必须集中在这些组织融合过程中发生的生物学过程以及更好的移植物处理和消毒技术上。目前，必须考虑疾病传播的风险并与患者进行讨论。
