PDF(Pubmed)
Abstract：
UNASSIGNED: Graft rupture is the most prevalent complication following pediatric anterior cruciate ligament reconstruction (ACLR). The hamstring tendon (HT) autograft is frequently employed, while the quadriceps tendon (QT) autograft has garnered increased attention recently. This study aims to perform a systematic review to assess the complication rates and functional outcomes associated with these two widely used autografts in skeletally immature patients - comparing HT versus QT autografts.
UNASSIGNED: Is QT autograft better than HT autograft for ACLR in skeletally immature cohorts?
UNASSIGNED: Three electronic databases (PubMed/Medline, Scopus, and Ovid) were comprehensively searched to identify pertinent articles reporting the outcomes of HT and QT autografts in pediatric ACLR with a minimum 2-year follow-up. Data on the outcome parameters, such as graft rupture rates, contralateral ACL injury rates, functional outcomes, and growth disturbances rates, were extracted. Meta-analysis was performed using OpenMeta Analyst software.
UNASSIGNED: Twelve studies were included for meta-analysis (pooled analysis) with 659 patients (QT: 205; HT: 454). The analysis showed that QT autografts had a significantly lesser graft rupture rate than HT autografts (3.5 % [95 % CI 0.2, 6.8] and 12.4 % [95 % CI 6.1, 18.7] respectively, p < 0.001). The graft rupture rates between QT with bone and without bone block showed no statistically significant difference (4.6 % [95 % CI 0.8, 1.0] and 3.5 % [95 % CI 2.0, 8.9] respectively, p = 0.181). The overall contralateral ACL injury rate was 10.2 %, and the subgroup analysis revealed no statistically significant difference between the QT and HT groups (p = 0.7). Regarding functional outcome scores at the final follow-up, the mean Lysholm score demonstrated a significant increase in the QT group compared to the HT group (p < 0.001). There were no significant differences between the two groups concerning growth disturbances at the final follow-up. Return to sports (RTS) varied between 6 and 13.5 months after surgery.
UNASSIGNED: QT autografts demonstrate encouraging outcomes, showcasing lower graft rupture rates, better functional outcomes, and comparable contralateral ACL injury rates and growth disturbances relative to the commonly used HT autograft in skeletally immature patients undergoing ACLR.
UNASSIGNED: Is QT autograft better than HT autograft for ACLR in skeletally immature cohorts?
UNASSIGNED: Three electronic databases (PubMed/Medline, Scopus, and Ovid) were comprehensively searched to identify pertinent articles reporting the outcomes of HT and QT autografts in pediatric ACLR with a minimum 2-year follow-up. Data on the outcome parameters, such as graft rupture rates, contralateral ACL injury rates, functional outcomes, and growth disturbances rates, were extracted. Meta-analysis was performed using OpenMeta Analyst software.
UNASSIGNED: Twelve studies were included for meta-analysis (pooled analysis) with 659 patients (QT: 205; HT: 454). The analysis showed that QT autografts had a significantly lesser graft rupture rate than HT autografts (3.5 % [95 % CI 0.2, 6.8] and 12.4 % [95 % CI 6.1, 18.7] respectively, p < 0.001). The graft rupture rates between QT with bone and without bone block showed no statistically significant difference (4.6 % [95 % CI 0.8, 1.0] and 3.5 % [95 % CI 2.0, 8.9] respectively, p = 0.181). The overall contralateral ACL injury rate was 10.2 %, and the subgroup analysis revealed no statistically significant difference between the QT and HT groups (p = 0.7). Regarding functional outcome scores at the final follow-up, the mean Lysholm score demonstrated a significant increase in the QT group compared to the HT group (p < 0.001). There were no significant differences between the two groups concerning growth disturbances at the final follow-up. Return to sports (RTS) varied between 6 and 13.5 months after surgery.
UNASSIGNED: QT autografts demonstrate encouraging outcomes, showcasing lower graft rupture rates, better functional outcomes, and comparable contralateral ACL injury rates and growth disturbances relative to the commonly used HT autograft in skeletally immature patients undergoing ACLR.
摘要：
■移植物破裂是小儿前交叉韧带重建术（ACLR）后最常见的并发症。经常采用绳肌腱（HT）自体移植，而股四头肌腱（QT）自体移植最近引起了越来越多的关注。这项研究旨在进行系统评价，以评估这两种广泛使用的自体移植物在骨骼未成熟患者中的并发症发生率和功能结果-比较HT和QT自体移植物。
在骨骼未成熟的队列中，QT自体移植是否比HT自体移植更好？
■三个电子数据库（PubMed/Medline，Scopus,和Ovid）进行了全面搜索，以确定相关文章，这些文章报道了至少2年随访的小儿ACLR中HT和QT自体移植物的结局。关于结果参数的数据，如移植物破裂率，对侧ACL损伤率,功能结果，和增长扰动率，被提取。使用OpenMetaAnalyst软件进行Meta分析。
■12项研究纳入了659例患者（QT：205；HT：454）的荟萃分析（汇总分析）。分析表明，QT自体移植物的移植物破裂率明显低于HT自体移植物（分别为3.5％[95％CI0.2，6.8]和12.4％[95％CI6.1，18.7]，p<0.001)。有骨块的QT和无骨块的QT之间的移植物破裂率差异无统计学意义（分别为4.6％[95％CI0.8，1.0]和3.5％[95％CI2.0，8.9]。p=0.181）。对侧ACL整体损伤率为10.2%,亚组分析显示，QT组和HT组之间无统计学差异（p=0.7）。关于最终随访时的功能结果评分，与HT组相比,QT组平均Lysholm评分显著升高(p<0.001).在最后的随访中，两组之间在生长障碍方面没有显着差异。恢复运动（RTS）在手术后6到13.5个月之间变化。
■QT自体移植显示出令人鼓舞的结果，展示较低的移植物破裂率，更好的功能结果，在接受ACLR的骨骼未成熟患者中，相对于常用的HT自体移植物，对侧ACL损伤率和生长障碍相当。
在骨骼未成熟的队列中，QT自体移植是否比HT自体移植更好？
■三个电子数据库（PubMed/Medline，Scopus,和Ovid）进行了全面搜索，以确定相关文章，这些文章报道了至少2年随访的小儿ACLR中HT和QT自体移植物的结局。关于结果参数的数据，如移植物破裂率，对侧ACL损伤率,功能结果，和增长扰动率，被提取。使用OpenMetaAnalyst软件进行Meta分析。
■12项研究纳入了659例患者（QT：205；HT：454）的荟萃分析（汇总分析）。分析表明，QT自体移植物的移植物破裂率明显低于HT自体移植物（分别为3.5％[95％CI0.2，6.8]和12.4％[95％CI6.1，18.7]，p<0.001)。有骨块的QT和无骨块的QT之间的移植物破裂率差异无统计学意义（分别为4.6％[95％CI0.8，1.0]和3.5％[95％CI2.0，8.9]。p=0.181）。对侧ACL整体损伤率为10.2%,亚组分析显示，QT组和HT组之间无统计学差异（p=0.7）。关于最终随访时的功能结果评分，与HT组相比,QT组平均Lysholm评分显著升高(p<0.001).在最后的随访中，两组之间在生长障碍方面没有显着差异。恢复运动（RTS）在手术后6到13.5个月之间变化。
■QT自体移植显示出令人鼓舞的结果，展示较低的移植物破裂率，更好的功能结果，在接受ACLR的骨骼未成熟患者中，相对于常用的HT自体移植物，对侧ACL损伤率和生长障碍相当。
