Abstract：
UNASSIGNED: New techniques are being developed to decrease the failure rate of anterior cruciate ligament (ACL) grafts and prevent revision surgery. One such technique involves high-strength suture tape (ST), also referred to as internal bracing. Recent literature has highlighted the use of ST for ACL reconstruction, but no study has compared ST augmentation between graft types.
UNASSIGNED: To compare the use of ST augmentation for ACL reconstruction based on the type of graft used (ie, bone-patellar tendon-bone [BPTB], quadriceps, hamstring).
UNASSIGNED: Systematic review; Level of evidence, 5.
UNASSIGNED: An online search of multiple databases was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was completed April 2022 to identify studies related to ST augmentation of ACL grafts.
UNASSIGNED: Of 926 studies identified, 10 met inclusion criteria. Five studies (50%) used hamstring tendon (HT), 3 (30%) used quadriceps tendon (QT), 1 (10%) used BPTB, and 1 (10%) used both HT and QT grafts. HT autografts augmented with ST had decreased dynamic and peak elongation (15%-56%), increased load to failure, and increased initial and final dynamic stiffness compared with controls. There was no significant difference in postoperative physical examination findings (range of motion, Lachman, pivot shift), except that ST-augmented grafts had significantly less laxity after surgery compared with HT alone (0.8 vs 1.9 mm; P < .05). QT allografts with ST augmentation showed increased graft strength. Human QT autograft studies showed higher Knee injury and Osteoarthritis Outcome Score scores compared with controls. BPTB allografts with ST augmentation had decreased cyclic displacement by 31% (P = .015) and increased load (758 ± 128 N; P < .001) and stiffness (156 ± 23 N/mm; P = .003) compared with nonaugmented groups. The complication rate was low or showed no increase in the ST augmentation groups compared with control groups.
UNASSIGNED: HT, QT, and BPTB grafts augmented with ST demonstrate an effective method for ACL reconstruction. All graft types with ST augmentation showed no evidence of clinical disadvantage, with some studies indicating significant biomechanical or clinical advantages compared with conventional ACL reconstruction.
UNASSIGNED: To compare the use of ST augmentation for ACL reconstruction based on the type of graft used (ie, bone-patellar tendon-bone [BPTB], quadriceps, hamstring).
UNASSIGNED: Systematic review; Level of evidence, 5.
UNASSIGNED: An online search of multiple databases was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was completed April 2022 to identify studies related to ST augmentation of ACL grafts.
UNASSIGNED: Of 926 studies identified, 10 met inclusion criteria. Five studies (50%) used hamstring tendon (HT), 3 (30%) used quadriceps tendon (QT), 1 (10%) used BPTB, and 1 (10%) used both HT and QT grafts. HT autografts augmented with ST had decreased dynamic and peak elongation (15%-56%), increased load to failure, and increased initial and final dynamic stiffness compared with controls. There was no significant difference in postoperative physical examination findings (range of motion, Lachman, pivot shift), except that ST-augmented grafts had significantly less laxity after surgery compared with HT alone (0.8 vs 1.9 mm; P < .05). QT allografts with ST augmentation showed increased graft strength. Human QT autograft studies showed higher Knee injury and Osteoarthritis Outcome Score scores compared with controls. BPTB allografts with ST augmentation had decreased cyclic displacement by 31% (P = .015) and increased load (758 ± 128 N; P < .001) and stiffness (156 ± 23 N/mm; P = .003) compared with nonaugmented groups. The complication rate was low or showed no increase in the ST augmentation groups compared with control groups.
UNASSIGNED: HT, QT, and BPTB grafts augmented with ST demonstrate an effective method for ACL reconstruction. All graft types with ST augmentation showed no evidence of clinical disadvantage, with some studies indicating significant biomechanical or clinical advantages compared with conventional ACL reconstruction.
摘要：
■正在开发新技术，以降低前交叉韧带（ACL）移植物的故障率并防止翻修手术。一种这样的技术涉及高强度缝合带（ST），也称为内部支撑。最近的文献强调了使用ST重建ACL，但没有研究比较不同类型的移植物的ST增强。
■根据所使用的移植物类型，比较使用ST增强进行ACL重建的情况（即，骨-髌腱-骨[BPTB]，股四头肌,腿筋）。
■系统评价；证据水平，5.
根据PRISMA（系统审查和荟萃分析的首选报告项目）指南对多个数据库进行在线搜索，并于2022年4月完成，以确定与ACL移植物ST段增强相关的研究。
■在确定的926项研究中，10符合纳入标准。五项研究（50％）使用了腿筋肌腱（HT），3（30％）使用股四头肌腱（QT），1（10％）使用BPTB，1例(10%)同时使用HT和QT移植物。ST增强的HT自体移植物的动态和峰值伸长率降低（15％-56％），增加故障负荷，与对照相比，初始和最终动态刚度增加。术后体格检查结果无显着差异（活动范围，拉赫曼,枢轴移位)，除了与单纯HT相比，ST增强的移植物在手术后的松弛度明显减少（0.8vs1.9mm；P<.05）。ST增强的QT同种异体移植物显示移植物强度增加。与对照组相比，人QT自体移植研究显示更高的膝关节损伤和骨关节炎结果评分。与未增强组相比，具有ST增强的BPTB同种异体移植物的循环位移减少了31％（P=.015），载荷增加（758±128N；P<.001）和刚度增加（156±23N/mm；P=.003）。与对照组相比，ST增强组的并发症发生率较低或没有增加。
■HT，QT,和ST增强的BPTB移植物证明了ACL重建的有效方法。所有ST段增大的移植物类型均未显示临床不利的证据，一些研究表明，与传统ACL重建相比，具有显着的生物力学或临床优势。
■根据所使用的移植物类型，比较使用ST增强进行ACL重建的情况（即，骨-髌腱-骨[BPTB]，股四头肌,腿筋）。
■系统评价；证据水平，5.
根据PRISMA（系统审查和荟萃分析的首选报告项目）指南对多个数据库进行在线搜索，并于2022年4月完成，以确定与ACL移植物ST段增强相关的研究。
■在确定的926项研究中，10符合纳入标准。五项研究（50％）使用了腿筋肌腱（HT），3（30％）使用股四头肌腱（QT），1（10％）使用BPTB，1例(10%)同时使用HT和QT移植物。ST增强的HT自体移植物的动态和峰值伸长率降低（15％-56％），增加故障负荷，与对照相比，初始和最终动态刚度增加。术后体格检查结果无显着差异（活动范围，拉赫曼,枢轴移位)，除了与单纯HT相比，ST增强的移植物在手术后的松弛度明显减少（0.8vs1.9mm；P<.05）。ST增强的QT同种异体移植物显示移植物强度增加。与对照组相比，人QT自体移植研究显示更高的膝关节损伤和骨关节炎结果评分。与未增强组相比，具有ST增强的BPTB同种异体移植物的循环位移减少了31％（P=.015），载荷增加（758±128N；P<.001）和刚度增加（156±23N/mm；P=.003）。与对照组相比，ST增强组的并发症发生率较低或没有增加。
■HT，QT,和ST增强的BPTB移植物证明了ACL重建的有效方法。所有ST段增大的移植物类型均未显示临床不利的证据，一些研究表明，与传统ACL重建相比，具有显着的生物力学或临床优势。
