Allograft tendons are a safe and effective option for revision ACL reconstruction: a clinical review
Allograft tendons are a safe and effective option for revision ACL reconstruction: a clinical review
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DOI：
10.1007/s00167-018-5147-4
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发表时间：
2019-06-01
影响因子：
3.8
通讯作者：
Kon, E.
中科院分区：
文献类型：
--
作者：
Condello, V.;Zdanowicz, U.;Kon, E.
翻修前交叉韧带重建仍然是一个挑战，特别是对于先前使用自体组织进行重建的膝关节受损患者的优化结果。同种异体移植组织已成为翻修手术中公认的移植物选择，但这种选择的风险和益处仍然存在问题。同种异体肌腱是一种安全有效的前交叉韧带翻修重建的选择，与自体移植物相比，如果组织没有照射或任何照射都是最小的，则没有更高的感染风险和相同的失败率。使用同种异体肌腱的最佳情况包括翻修手术，在这种情况下，进一步使用自体移植物可能导致供体部位的高发病率，复杂的不稳定情况下，可能需要重建额外的结构，以及有临床和放射学迹象的自体肌腱退变。对于具有挑战性的前交叉韧带重建，外科医生需要能够选择最佳方案，根据目前的数据，同种异体移植组织可以被认为是实现这一目的的合适选择。
Revision anterior cruciate ligament reconstruction remains a challenge, especially optimising outcome for patients with a compromised knee where previous autogenous tissue has been used for reconstruction. Allograft tissue has become a recognized choice of graft for revision surgery but questions remain over the risks and benefits of such an option. Allograft tendons are a safe and effective option for revision ACL reconstruction with no higher risk of infection and equivalent failure rates compared to autografts provided that the tissue is not irradiated, or any irradiation is minimal. Best scenarios for use of allografts include revision surgery where further use of autografts could lead to high donor site morbidity, complex instability situations where additional structures may need reconstruction, and in those with clinical and radiologic signs of autologous tendon degeneration. A surgeon needs to be able to select the best option for the challenging knee facing revision ACL reconstruction, and in the light of current data, allograft tissue can be considered a suitable option to this purpose.