Noyes F R, Barber-Westin S D
Sports Medicine Research Department, Deaconess Hospital, Cincinnati, OH, USA.
Clin Orthop Relat Res. 1996 Apr(325):116-29. doi: 10.1097/00003086-199604000-00013.
Prospective studies were done to determine the outcome of allografts and autografts used for revision anterior cruciate ligament reconstruction. The allograft group was comprised of 65 patients observed for a mean of 42 months postoperatively; the autograft (bone-patellar ligament-bone) group contained 20 patients observed for a mean of 27 months postoperatively. KT-2000 testing and a comprehensive knee examination were done on all the patients. The Cincinnati Knee Rating System was used for assessment. Significant improvements were noted in all patients for symptoms, functional limitations, anteroposterior displacements, pivot shift tests, and overall rating scores. KT-2000 results showed 53% of the allograft group and 67% of the autograft group had less than 3 mm increased displacement (not statistically significant). The overall failure rates were 33% for the allografts and 27% for the autografts. Preoperative planning and technical aspects of anterior cruciate ligament revision procedures are described. The authors prefer bone-patellar ligament-bone autografts for anterior cruciate ligament revision, although the data presented were considered preliminary. Bone-patellar ligament-bone allografts may be used when autogenous tissues are not available, because they offer reasonable success rates for patients who are symptomatic with daily activities.
开展前瞻性研究以确定用于翻修前交叉韧带重建的同种异体移植物和自体移植物的转归情况。同种异体移植物组由65例患者组成，术后平均观察42个月；自体移植物（骨-髌腱-骨）组有20例患者，术后平均观察27个月。对所有患者均进行了KT-2000测试和全面的膝关节检查。采用辛辛那提膝关节评分系统进行评估。所有患者在症状、功能受限、前后移位、轴移试验及总体评分方面均有显著改善。KT-2000结果显示，同种异体移植物组53%的患者和自体移植物组67%的患者移位增加小于3 mm（无统计学意义）。同种异体移植物的总体失败率为33%，自体移植物为27%。文中描述了前交叉韧带翻修手术的术前规划和技术要点。尽管所呈现的数据被认为是初步的，但作者更倾向于采用骨-髌腱-骨自体移植物进行前交叉韧带翻修。当无法获取自体组织时，可使用骨-髌腱-骨同种异体移植物，因为对于日常活动有症状的患者，其成功率较为合理。
