目的:对使用对侧或同侧肌腱自体移植重建前交叉韧带的临床结果进行系统评价。
方法:对从成立到2022年12月9日在多个数据库中发表的文献进行系统回顾(PubMed,Embase,Scopus,和Cochrane图书馆)按照2020PRISMA(系统审查的首选报告项目)指南进行。两位审稿人独立筛选了文献,提取数据,进行偏倚风险评估并评估研究质量.对每项研究至少评估了以下结果之一:肌肉力量(股四头肌或腿筋肌肉的等距力量,腿筋的等速峰值屈曲扭矩,或腿筋的等速峰值伸展扭矩),膝关节松弛度检查,Lysholm得分,枢轴移位,国际膝关节文献委员会(IKDC)评分,膝关节损伤和骨关节炎结果评分(KOOS),拉赫曼测试结果,回到运动时间,或并发症的发生率。随机效应模型用于所有分析。
结果:在最初的搜索中发现了400份科学手稿。筛选后,12项研究(2项随机对照试验,9项队列研究,和1例病例对照研究)符合定性分析的搜索标准。其中,9项队列研究用于定量分析。结果显示,在肌肉力量方面(对侧组与同侧组或供体部位组与同侧组或供体部位组与非手术组)没有统计学上的显着差异,Lysholm得分,回到运动时间。比较显示膝关节松弛没有显着差异,IKDC评分,Tegner活动得分,拉赫曼考试成绩,或并发症的发生率,或对侧破裂。
结论:在前交叉韧带重建中,对侧自体肌腱与同侧自体肌腱具有相似的作用.
OBJECTIVE: To perform a systematic review of the clinical outcomes of anterior cruciate ligament reconstruction using either contralateral or
ipsilateral tendon autografts.
METHODS: A systematic review of literature published from inception to December 9, 2022, in multiple databases (PubMed, Embase, Scopus, and the Cochrane Library) was conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews) guidelines. Two reviewers independently screened the literature, extracted the data, performed the risk of bias assessment and assessed the study quality. At least one of the following outcomes was evaluated for each study: muscle strength (isometric strength of the quadriceps or hamstring muscles, isokinetic peak flexion torque of the hamstring, or isokinetic peak extension torque of the hamstring), knee laxity examination, Lysholm score, pivot shift, International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Lachman test result, return to sports time, or incidence of complications. A random effects model was used for all analyses.
RESULTS: Four hundred scientific manuscripts were recovered in the initial search. After screening, 12 studies (2 randomized controlled trials, 9 cohort studies, and 1 case- control study) met the search criteria for the qualitative analysis. Among them, 9 cohort studies were used for the quantitative analysis. The results showed few statistically significant differences in terms of muscle strength (contralateral group versus
ipsilateral group or donor site group versus
ipsilateral group or donor site group versus nonoperative group), Lysholm score, and return to sports time. A comparison showed no significant differences in knee laxity, IKDC score, Tegner activity score, Lachman test score, or incidence of complication, or contralateral rupture.
CONCLUSIONS: In anterior cruciate ligament reconstruction, the contralateral autologous tendon has a similar effect as the
ipsilateral autologous tendon.