Arthroscopic anterior cruciate ligament reconstruction: A metaanalysis comparing patellar tendon and hamstring tendon autografts
Arthroscopic anterior cruciate ligament reconstruction: A metaanalysis comparing patellar tendon and hamstring tendon autografts
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DOI：
10.1177/03635465030310011501
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发表时间：
2003-01-01
影响因子：
4.8
通讯作者：
Bach, BR
中科院分区：
文献类型：
--
作者：
Freedman, KB;D'Amato, MJ;Bach, BR
背景：前交叉韧带重建术中移植组织的最佳选择一直是争论的主题。研究设计：荟萃分析。方法：Medline检索1966年1月至2000年5月发表的文章，描述关节镜下自体髌腱或自体腿肌腱重建前十字韧带，患者至少随访24个月。结果：共有1348名患者(21项研究)和628名患者(113项研究)在关节镜下重建前十字韧带。在移植物失败率方面，髌腱组显著低于肌腱组(1.9%对4.9%)，而在KT-1000关节测量仪测试中两侧差小于3 mm的患者比例显著高于腿筋组(79%对73.8%)。在麻醉或粘连松解的情况下，膝关节前疼痛发生率和膝关节前疼痛发生率分别为6.3%和11.5%，分别为6.3%和11.5%。结论：与自体腿肌腱相比，自体膝关节移植物移植物的移植物失败率明显降低，膝关节静态稳定性更好，患者满意度更高。然而，自体髌腱重建术导致膝关节前疼痛的发生率增加。(C)2003年美国整形外科运动医学学会。
Background: The best choice of graft tissue for use in anterior cruciate ligament reconstruction has been the subject of debate. Hypothesis: Anterior cruciate ligament reconstruction with patellar tendon autograft leads to greater knee stability than reconstruction with hamstring tendon autograft.Study Design: Metaanalysis.Methods: A Medline search identified articles published from January 1966 to May 2000 describing arthroscopic anterior cruciate ligament reconstruction with either patellar tendon or hamstring tendon autograft and with a minimum patient follow-up of 24 months.Results: There were 1348 patients in the patellar tendon group (21 studies) and 628 patients in the hamstring tendon group (113 studies). The rate of graft failure in the patellar tendon group was significantly lower (1.9% versus 4.9%) and a significantly higher proportion of patients in the patellar tendon group had a side-to-side difference of less than 3 mm on KT-1000 arthrometer testing than in the hamstring tendon group (79% versus 73.8%). There was a higher rate of manipulation under anesthesia or lysis of adhesions (6.3% versus 3.3%) and of anterior knee pain in the patellar tendon group (17.4% versus 11.5%) and a higher incidence of hardware removal in the hamstring tendon group (5.5% versus 3.1%).Conclusions: Patellar tendon autografts had a significantly lower rate of graft failure and resulted in better static knee stability and increased patient satisfaction compared with hamstring tendon autografts. However, patellar tendon autograft reconstructions resulted in an increased rate of anterior knee pain. (C) 2003 American Orthopaedic Society for Sports Medicine.