Abstract：
OBJECTIVE: To perform a systematic review evaluating clinical outcomes in patients undergoing medial ulnar collateral ligament reconstruction (MUCLR) with soft-tissue allograft.
METHODS: A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcomes evaluated were patient-reported outcome scores, return to play (RTP) rates, incidence of postoperative complications, and rates of graft rupture or mechanical failure.
RESULTS: The literature search identified 395 articles, and 5 studies met final inclusion criteria after full-text review. A total of 274 patients were analyzed in the included studies and follow-up ranged from 3.0 to 7.6 years. Two studies (number of patients = 141) reported outcomes exclusively of MUCLR with allograft, whereas 3 studies (number of patients = 133) reported outcomes in patients undergoing MUCLR with either allograft or autograft. Allograft sources included gracilis, semitendinosus, plantaris, peroneus longus, and palmaris longus. Level of patient athletic competition ranged from recreational athletes to the professional level; however, nonathletes in the setting of trauma were also included. The RTP rate after MUCLR with soft-tissue allograft was 95.3%, and 89.3% of patients returned to a similar or greater level of play postoperatively. The Timmerman-Andrews score was reported in 2 studies, and the means postoperatively ranged from 94.55 to 97. Postoperative complication rates were low (range, 0% to 20%), and there were no reported incidences of allograft rupture or mechanical failure.
CONCLUSIONS: Based on the available data, soft-tissue allograft for MUCLR in athletic patient populations provides excellent clinical outcomes, high rates of RTP, and low rates of postoperative complications and graft failure at short-term follow-up. There remains a lack of high-quality evidence directly comparing autograft versus allograft outcomes in elite overhead-throwing athletes to support allograft as an acceptable alternative for MUCLR in this patient population. LEVEL OF EVIDENCE: Level IV, systematic review of Level III-IV studies.
METHODS: A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcomes evaluated were patient-reported outcome scores, return to play (RTP) rates, incidence of postoperative complications, and rates of graft rupture or mechanical failure.
RESULTS: The literature search identified 395 articles, and 5 studies met final inclusion criteria after full-text review. A total of 274 patients were analyzed in the included studies and follow-up ranged from 3.0 to 7.6 years. Two studies (number of patients = 141) reported outcomes exclusively of MUCLR with allograft, whereas 3 studies (number of patients = 133) reported outcomes in patients undergoing MUCLR with either allograft or autograft. Allograft sources included gracilis, semitendinosus, plantaris, peroneus longus, and palmaris longus. Level of patient athletic competition ranged from recreational athletes to the professional level; however, nonathletes in the setting of trauma were also included. The RTP rate after MUCLR with soft-tissue allograft was 95.3%, and 89.3% of patients returned to a similar or greater level of play postoperatively. The Timmerman-Andrews score was reported in 2 studies, and the means postoperatively ranged from 94.55 to 97. Postoperative complication rates were low (range, 0% to 20%), and there were no reported incidences of allograft rupture or mechanical failure.
CONCLUSIONS: Based on the available data, soft-tissue allograft for MUCLR in athletic patient populations provides excellent clinical outcomes, high rates of RTP, and low rates of postoperative complications and graft failure at short-term follow-up. There remains a lack of high-quality evidence directly comparing autograft versus allograft outcomes in elite overhead-throwing athletes to support allograft as an acceptable alternative for MUCLR in this patient population. LEVEL OF EVIDENCE: Level IV, systematic review of Level III-IV studies.
摘要：
目的：对同种异体软组织内侧尺侧副韧带重建（MUCLR）患者的临床疗效进行系统评价。
方法：根据系统评价和荟萃分析（PRISMA）指南的首选报告项目对文献进行系统评价。评估的主要结果是患者报告的结果评分，返回播放(RTP)费率，术后并发症的发生率，以及移植物破裂或机械故障的发生率。
结果：在全文回顾后，文献检索确定了395篇文章和5项研究符合最终纳入标准。在纳入的研究中，共分析了274例患者，随访时间为3.0至7.6年。两项研究（n患者=141）报道了同种异体移植MUCLR的结果，而三项研究(n患者=133)报道了接受同种异体移植或自体移植的MUCLR患者的结局。同种异体移植源包括gracilis，半腱肌,plantaris,长腓骨,还有PalmarisLongus.患者体育比赛的水平从休闲运动员到专业水平不等，然而,创伤设置中的非运动员也包括在内.MUCLR软组织移植后的RTP率为95.3%，89.3%的患者术后恢复到相似或更高的游戏水平。Timmerman-Andrews评分在两项研究中报告，术后平均值为94.55至97。术后并发症发生率低（范围，0％至20％），并且没有同种异体移植破裂或机械故障的报告。
结论：根据现有数据，在运动患者人群中用于MUCLR的软组织同种异体移植提供了出色的临床结果，RTP的高比率，术后并发症和移植失败的发生率较低。仍然缺乏高质量的证据，直接比较精英高架投掷运动员的自体移植物与同种异体移植物的结果，以支持同种异体移植物作为该患者人群中MUCLR的可接受替代方案。
方法：根据系统评价和荟萃分析（PRISMA）指南的首选报告项目对文献进行系统评价。评估的主要结果是患者报告的结果评分，返回播放(RTP)费率，术后并发症的发生率，以及移植物破裂或机械故障的发生率。
结果：在全文回顾后，文献检索确定了395篇文章和5项研究符合最终纳入标准。在纳入的研究中，共分析了274例患者，随访时间为3.0至7.6年。两项研究（n患者=141）报道了同种异体移植MUCLR的结果，而三项研究(n患者=133)报道了接受同种异体移植或自体移植的MUCLR患者的结局。同种异体移植源包括gracilis，半腱肌,plantaris,长腓骨,还有PalmarisLongus.患者体育比赛的水平从休闲运动员到专业水平不等，然而,创伤设置中的非运动员也包括在内.MUCLR软组织移植后的RTP率为95.3%，89.3%的患者术后恢复到相似或更高的游戏水平。Timmerman-Andrews评分在两项研究中报告，术后平均值为94.55至97。术后并发症发生率低（范围，0％至20％），并且没有同种异体移植破裂或机械故障的报告。
结论：根据现有数据，在运动患者人群中用于MUCLR的软组织同种异体移植提供了出色的临床结果，RTP的高比率，术后并发症和移植失败的发生率较低。仍然缺乏高质量的证据，直接比较精英高架投掷运动员的自体移植物与同种异体移植物的结果，以支持同种异体移植物作为该患者人群中MUCLR的可接受替代方案。
