METHODS: A comprehensive search of published literature in PubMed, Web of Science, Cochrane Library, Ovid, and EMBASE databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria included patients undergoing ACLR with PLT autograft, inclusion of patient-recorded outcome measures, and availability in English language. Publications that included only biomechanical analysis or ACLR with use of allograft or combination grafts were excluded.
RESULTS: A total of 16 studies (Level of Evidence range: I-IV) met inclusion criteria, with follow-up ranging from 3 months to 5 years. In the available case series, patient-reported outcomes ranged from Lysholm = 80.7 to 95.1, International Knee Documentation Committee 78.1 to 95.7. In prospective cohorts and randomized controlled trials, PLT performance was comparable with HT autografts (PLT/HT: Lysholm = 88.3-95.1/86.5-94.9, International Knee Documentation Committee = 78.2-92.5/87.4-93.4). The majority of PLT grafts diameters were equal or greater than HT counterparts with a mean of >8 mm (PLT/HT: 7.0-9.0 mm/7.65-8.5 mm). There was minimal donor-site morbidity associated with PLT harvest.
CONCLUSIONS: Although limitations exist within the available literature, existing evidence suggests that PLT autograft routinely produces adequately sized grafts with comparable early outcomes to HT autograft and low risk of donor-site morbidity. However, the PLT autograft is yet to demonstrate superiority to any of the more-traditional autograft selections.
METHODS: Level IV, systematic review of Level I-IV studies.
方法:对Pub-Med,WebofScience,科克伦图书馆,Ovid和EMBASE数据库是根据系统审查和Met分析(PRISMA)指南的首选报告项目进行的。纳入标准包括接受ACLR与PLT自体移植的患者,纳入患者记录的结果测量,以及英语语言的可用性。仅包括生物力学分析的出版物,排除使用同种异体移植物或组合移植物的ACLR。
结果:共有16项研究(证据水平范围:I-IV)符合纳入标准,随访时间为3个月至5年。在可用的案例系列中,患者报告的结局范围为Lyshom=80.7-95.1,IKDC78.1-95.7.在前瞻性队列和随机对照试验中,PLT性能与绳肌腱(HT)自体移植物相当(PLT/HT:Lysholm=88.3-95.1/86.5-94.9,IKDC=78.2-92.5/87.4-93.4)。大多数PLT移植物直径等于或大于HT对应物,平均>8mm(PLT/HT:7.0-9.0mm/7.65-8.5mm)。与PLT收获相关的供体部位发病率最低。
结论:尽管现有文献中存在限制,现有证据表明,PLT自体移植物常规产生足够大小的移植物,其早期结局与HT自体移植物相当,且供体部位发病率低.然而,PLT自体移植物尚未显示出优于任何更传统的自体移植物选择。