{"title":"骨髌骨 骨异体移植在前交叉韧带翻修重建中显示出卓越的疗效：系统回顾和荟萃分析。","authors":"Yuvraj Chhabra , Sarup Saroha , Kamrul Hasan , Raj Thakrar , Akash Patel","doi":"10.1016/j.knee.2024.09.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Backgrounds and Aims</h3><div>This study explores the impact of allograft selection in revision ACL reconstruction (RACLR). Allografts reduce donor-site morbidity and surgery duration but are costly and may prolong graft integration times. We aimed to assess various allograft subtypes for their efficacy and failure rates in RACLR.</div></div><div><h3>Materials and Methods</h3><div>Following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and a pre-defined protocol (ID: CRD42023432517), a systematic review of Cochrane Library, Embase, MEDLINE, Web of Science, and Scopus was performed for allograft studies. The primary outcome was failure rate (graft re-rupture/revision). Secondary outcomes included functional scores, infection rates, and return to sport levels. The <em>meta</em>-analysis weighted studies by standard error.</div></div><div><h3>Results</h3><div>Studies assessing Bone Patella Bone (BPTB), Tibialis Anterior, and Achilles allografts were included. The results indicate non-statistically significant odds ratios when comparing re-rupture rates for BPTB versus both Achilles (OR 3.69) and Tibialis Anterior (OR 1.26) with low or no heterogeneity. Tibialis Anterior displayed a lower failure rate than Achilles (OR 1.26 vs. 3.69). Secondary outcomes favoured BPTB, showing positive KOOS and IKDC scores, while Achilles reported Lysholm scores (83.8 ± 11.3) and 62% return to sport. Tibialis Anterior outcomes included a Lysholm score (92 ± 4.0).</div></div><div><h3>Conclusion</h3><div>This study provides insights into graft selection for RACLR. BPTB demonstrated favourable graft failure rates compared to Tibialis Anterior and Achilles allografts. No statistically significant differences were observed in other outcomes between subtypes, emphasising the need for standardised reporting in RACLR studies and supporting avenues for future research.</div></div>","PeriodicalId":56110,"journal":{"name":"Knee","volume":"51 ","pages":"Pages 206-220"},"PeriodicalIF":1.6000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Bone Patella Bone allografts show superior outcomes in revision ACL reconstruction: A systematic review and meta-analysis\",\"authors\":\"Yuvraj Chhabra , Sarup Saroha , Kamrul Hasan , Raj Thakrar , Akash Patel\",\"doi\":\"10.1016/j.knee.2024.09.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Backgrounds and Aims</h3><div>This study explores the impact of allograft selection in revision ACL reconstruction (RACLR). Allografts reduce donor-site morbidity and surgery duration but are costly and may prolong graft integration times. We aimed to assess various allograft subtypes for their efficacy and failure rates in RACLR.</div></div><div><h3>Materials and Methods</h3><div>Following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and a pre-defined protocol (ID: CRD42023432517), a systematic review of Cochrane Library, Embase, MEDLINE, Web of Science, and Scopus was performed for allograft studies. The primary outcome was failure rate (graft re-rupture/revision). Secondary outcomes included functional scores, infection rates, and return to sport levels. The <em>meta</em>-analysis weighted studies by standard error.</div></div><div><h3>Results</h3><div>Studies assessing Bone Patella Bone (BPTB), Tibialis Anterior, and Achilles allografts were included. The results indicate non-statistically significant odds ratios when comparing re-rupture rates for BPTB versus both Achilles (OR 3.69) and Tibialis Anterior (OR 1.26) with low or no heterogeneity. Tibialis Anterior displayed a lower failure rate than Achilles (OR 1.26 vs. 3.69). Secondary outcomes favoured BPTB, showing positive KOOS and IKDC scores, while Achilles reported Lysholm scores (83.8 ± 11.3) and 62% return to sport. Tibialis Anterior outcomes included a Lysholm score (92 ± 4.0).</div></div><div><h3>Conclusion</h3><div>This study provides insights into graft selection for RACLR. BPTB demonstrated favourable graft failure rates compared to Tibialis Anterior and Achilles allografts. No statistically significant differences were observed in other outcomes between subtypes, emphasising the need for standardised reporting in RACLR studies and supporting avenues for future research.</div></div>\",\"PeriodicalId\":56110,\"journal\":{\"name\":\"Knee\",\"volume\":\"51 \",\"pages\":\"Pages 206-220\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0968016024001601\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0968016024001601","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Bone Patella Bone allografts show superior outcomes in revision ACL reconstruction: A systematic review and meta-analysis
Backgrounds and Aims
This study explores the impact of allograft selection in revision ACL reconstruction (RACLR). Allografts reduce donor-site morbidity and surgery duration but are costly and may prolong graft integration times. We aimed to assess various allograft subtypes for their efficacy and failure rates in RACLR.
Materials and Methods
Following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and a pre-defined protocol (ID: CRD42023432517), a systematic review of Cochrane Library, Embase, MEDLINE, Web of Science, and Scopus was performed for allograft studies. The primary outcome was failure rate (graft re-rupture/revision). Secondary outcomes included functional scores, infection rates, and return to sport levels. The meta-analysis weighted studies by standard error.
Results
Studies assessing Bone Patella Bone (BPTB), Tibialis Anterior, and Achilles allografts were included. The results indicate non-statistically significant odds ratios when comparing re-rupture rates for BPTB versus both Achilles (OR 3.69) and Tibialis Anterior (OR 1.26) with low or no heterogeneity. Tibialis Anterior displayed a lower failure rate than Achilles (OR 1.26 vs. 3.69). Secondary outcomes favoured BPTB, showing positive KOOS and IKDC scores, while Achilles reported Lysholm scores (83.8 ± 11.3) and 62% return to sport. Tibialis Anterior outcomes included a Lysholm score (92 ± 4.0).
Conclusion
This study provides insights into graft selection for RACLR. BPTB demonstrated favourable graft failure rates compared to Tibialis Anterior and Achilles allografts. No statistically significant differences were observed in other outcomes between subtypes, emphasising the need for standardised reporting in RACLR studies and supporting avenues for future research.
期刊介绍：
The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee.
The topics covered include, but are not limited to:
• Anatomy, physiology, morphology and biochemistry;
• Biomechanical studies;
• Advances in the development of prosthetic, orthotic and augmentation devices;
• Imaging and diagnostic techniques;
• Pathology;
• Trauma;
• Surgery;
• Rehabilitation.
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