PDF(Pubmed)
Abstract：
UNASSIGNED: Allograft tendons are perceived to have a high ACL graft failure rate in primary anterior cruciate ligament (ACL) reconstruction (ACLR). Historical series may be biased by graft processing methods that degrade the biomechanical properties of donor tendons such as irradiation. Supercritical carbon dioxide (SCCO2) is a validated method of terminally sterilizing biomaterials at physiological temperatures without irradiation, but in vivo use of SCCO2-processed tendon allografts for primary ACLR has not been reported to date.
UNASSIGNED: ACLR with SCCO2 allografts would result in acceptable failure rates, subjective knee scores, and clinical evaluation at 2 years postoperatively.
UNASSIGNED: Case series; Level of evidence, 4.
UNASSIGNED: Patients underwent primary ACLR with terminally sterilized SCCO2-processed human gracilis, peroneus longus, semitendinosus, tibialis anterior, and tibialis posterior tendon allografts. Patient demographics were collected, along with tendon donor age and sex. At 1 year postoperatively, subjective International Knee Documentation Committee (IKDC) and ACL-Return to Sport After Injury (ACL-RSI) scores were collected, as well as clinical evaluation. At 2 years postoperatively, the IKDC and ACL-RSI scores were repeated, and return to sports and further knee injuries were recorded.
UNASSIGNED: A total of 144 patients with a medianage of 26 (IQR 14) years formed the study group. Patients were predominately male (58%). The loss to follow-up rate was 8% (n = 12). The mean age of allograft tendon donors was 37 (range 17-58) years, and the majority were male (83%). The mean allograft diameter was 8.9 ± 1.0 mm. At 2 years, ACL graft failureoccurred in 5% (n = 7). All graft failureswere in patients aged ≤25 years (P = .007). Neither donor age (≤40 or >40 years) nor donor sex was associated with graft failure (P > .05). The median IKDC subjective score was 95 and ACL-RSI score was 75. There were no revisions for sepsis within the first 2 years postoperatively.
UNASSIGNED: SCCO2 processing of allograft tendons demonstrated satisfactory clinical and patient-reported outcomes at 24 months postoperatively in a consecutive series of patients with primary ACLR, with similar ACL graft failure rates and subjective knee scores compared with those reported in published series of hamstring tendon autograft and fresh frozen nonirradiated allograft.
UNASSIGNED: ACLR with SCCO2 allografts would result in acceptable failure rates, subjective knee scores, and clinical evaluation at 2 years postoperatively.
UNASSIGNED: Case series; Level of evidence, 4.
UNASSIGNED: Patients underwent primary ACLR with terminally sterilized SCCO2-processed human gracilis, peroneus longus, semitendinosus, tibialis anterior, and tibialis posterior tendon allografts. Patient demographics were collected, along with tendon donor age and sex. At 1 year postoperatively, subjective International Knee Documentation Committee (IKDC) and ACL-Return to Sport After Injury (ACL-RSI) scores were collected, as well as clinical evaluation. At 2 years postoperatively, the IKDC and ACL-RSI scores were repeated, and return to sports and further knee injuries were recorded.
UNASSIGNED: A total of 144 patients with a medianage of 26 (IQR 14) years formed the study group. Patients were predominately male (58%). The loss to follow-up rate was 8% (n = 12). The mean age of allograft tendon donors was 37 (range 17-58) years, and the majority were male (83%). The mean allograft diameter was 8.9 ± 1.0 mm. At 2 years, ACL graft failureoccurred in 5% (n = 7). All graft failureswere in patients aged ≤25 years (P = .007). Neither donor age (≤40 or >40 years) nor donor sex was associated with graft failure (P > .05). The median IKDC subjective score was 95 and ACL-RSI score was 75. There were no revisions for sepsis within the first 2 years postoperatively.
UNASSIGNED: SCCO2 processing of allograft tendons demonstrated satisfactory clinical and patient-reported outcomes at 24 months postoperatively in a consecutive series of patients with primary ACLR, with similar ACL graft failure rates and subjective knee scores compared with those reported in published series of hamstring tendon autograft and fresh frozen nonirradiated allograft.
摘要：
■在原发性前交叉韧带（ACL）重建（ACLR）中，同种异体肌腱被认为具有较高的ACL移植失败率。历史系列可能会因移植物处理方法而产生偏差，这些方法会降低供体肌腱的生物力学特性，例如辐照。超临界二氧化碳（SCCO2）是一种在生理温度下对生物材料进行最终灭菌而无需辐照的有效方法，但迄今为止尚未报道SCCO2处理的同种异体肌腱移植物用于原发性ACLR。
■使用SCCO2同种异体移植物的ACLR将导致可接受的故障率，主观膝关节评分,术后2年进行临床评估。
■案例系列；证据级别，4.
■患者接受了经最终灭菌的SCCO2处理的人gracilis的初级ACLR，长腓骨,半腱肌,胫骨前肌,和胫骨后肌腱同种异体移植。收集患者的人口统计数据，随着肌腱供体的年龄和性别。术后1年，收集主观国际膝关节文献委员会（IKDC）和ACL-受伤后恢复运动（ACL-RSI）评分，以及临床评估。术后2年，重复IKDC和ACL-RSI评分，并恢复运动，并记录了进一步的膝盖受伤。
■总共144名中等年龄为26（IQR14）岁的患者组成了研究组。患者主要为男性（58%）。随访损失率为8%(n=12)。同种异体肌腱供体的平均年龄为37岁（17-58岁），大多数是男性（83％）。平均同种异体移植物直径为8.9±1.0mm。在2年,ACL移植失败发生率为5%(n=7)。所有移植失败的患者年龄≤25岁（P=.007）。供体年龄（≤40岁或>40岁）和供体性别均与移植失败无关（P>.05）。IKDC主观评分中位数为95分，ACL-RSI评分中位数为75分。术后前2年内未对脓毒症进行修订。
■SCCO2处理同种异体肌腱在连续一系列原发性ACLR患者术后24个月显示出令人满意的临床和患者报告结果。与已发表的腿筋肌腱自体移植和新鲜冷冻的未经辐照的同种异体移植系列报道相比，ACL移植失败率和主观膝关节评分相似。
■使用SCCO2同种异体移植物的ACLR将导致可接受的故障率，主观膝关节评分,术后2年进行临床评估。
■案例系列；证据级别，4.
■患者接受了经最终灭菌的SCCO2处理的人gracilis的初级ACLR，长腓骨,半腱肌,胫骨前肌,和胫骨后肌腱同种异体移植。收集患者的人口统计数据，随着肌腱供体的年龄和性别。术后1年，收集主观国际膝关节文献委员会（IKDC）和ACL-受伤后恢复运动（ACL-RSI）评分，以及临床评估。术后2年，重复IKDC和ACL-RSI评分，并恢复运动，并记录了进一步的膝盖受伤。
■总共144名中等年龄为26（IQR14）岁的患者组成了研究组。患者主要为男性（58%）。随访损失率为8%(n=12)。同种异体肌腱供体的平均年龄为37岁（17-58岁），大多数是男性（83％）。平均同种异体移植物直径为8.9±1.0mm。在2年,ACL移植失败发生率为5%(n=7)。所有移植失败的患者年龄≤25岁（P=.007）。供体年龄（≤40岁或>40岁）和供体性别均与移植失败无关（P>.05）。IKDC主观评分中位数为95分，ACL-RSI评分中位数为75分。术后前2年内未对脓毒症进行修订。
■SCCO2处理同种异体肌腱在连续一系列原发性ACLR患者术后24个月显示出令人满意的临床和患者报告结果。与已发表的腿筋肌腱自体移植和新鲜冷冻的未经辐照的同种异体移植系列报道相比，ACL移植失败率和主观膝关节评分相似。
