Gögüs A, Lobenhoffer P, Tscherne H
Orthopädische und Traumatologische Klinik, Medizinische Fakultät der Universität Istanbul.
Unfallchirurg. 1993 Feb;96(2):93-9.
There is a continuing search for the ideal substitute for the cruciate ligaments. Autogenous tissues have been widely used as a replacement. The use of allografts is an attractive alternative: no donor side morbidity, decreased operative time, smaller incisions, especially with new endoscopic techniques, unlimited supply with a choice of graft sizes in multiple ligament reconstructions and a long shelf-life are some of the distinct advantages that allografts offer. They may be useful in circumstances where there is no suitable autologous substitute or the available tendon is too short to span the joint cavity. The preparation of an allograft requires appropriate donor selection and screening, careful surgical tissue procurement, and safe and effective processing techniques. At the present time, the issue of secondary sterilization of allografts remains controversial. Subclinical immune response and the possibility of transmission of infectious agents have to be considered. The early results in the literature and in our small series are encouraging; however, long-term results are necessary prior to widespread use of allografts in cruciate ligaments reconstructions. The authors believe that allografts should presently be reserved for use as an alternative to prosthetic ligaments in situations where autografts are unavailable or inappropriate.
人们一直在不断寻找十字韧带的理想替代物。自体组织已被广泛用作替代材料。同种异体移植物是一种有吸引力的选择：无供体部位发病率、手术时间缩短、切口更小，尤其是采用新的内镜技术时，在多韧带重建中供应不受限且可选择移植物大小，以及保质期长，这些都是同种异体移植物的一些显著优点。在没有合适的自体替代物或可用肌腱太短无法跨越关节腔的情况下，它们可能会很有用。同种异体移植物的制备需要进行适当的供体选择和筛查、仔细的手术组织获取以及安全有效的处理技术。目前，同种异体移植物的二次灭菌问题仍存在争议。必须考虑亚临床免疫反应和感染因子传播的可能性。文献中的早期结果以及我们的小样本系列结果令人鼓舞；然而，在十字韧带重建中广泛使用同种异体移植物之前，还需要长期结果。作者认为，目前同种异体移植物应保留用作在自体移植物不可用或不合适的情况下替代人工韧带的选择。
