{"title":"骨骼不成熟患者的同种异体移植与自体移植前交叉韧带重建：系统性综述。","authors":"Filippo Migliorini, Marco Pilone, Luise Schäfer, Francesca Alzira Bertini, Riccardo Giorgino, Nicola Maffulli","doi":"10.1093/bmb/ldae020","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Anterior cruciate ligament (ACL) injuries in children and adolescents with open physes are common.</p><p><strong>Areas of agreement: </strong>Evidence of ACL reconstruction using allografts in children with open physes is limited.</p><p><strong>Areas of controversy: </strong>Whether the outcomes of ACL allograft reconstruction in children and adolescents with open physes are superior to autograft ACL reconstruction is unclear, with contrasting evidence.</p><p><strong>Source of data: </strong>In October 2024, the Web of Science, PubMed, and Embase were accessed with no additional filters. Only clinical investigations evaluating ACL reconstruction in children or adolescents with open physes were eligible. Only studies reporting a minimum length of 24 months of follow-up were included.</p><p><strong>Areas timely for developing research: </strong>Children who undergo allograft ACL reconstruction demonstrate similar functional outcomes to those who undergo autograft ACL reconstruction. Although allografts allow a faster return to sport, the greater laxity, the reduced activity level, and the higher failure and reoperation rates make their use dubious as a first-choice option for ACL reconstruction in skeletally immature patients.</p>","PeriodicalId":9280,"journal":{"name":"British medical bulletin","volume":" ","pages":""},"PeriodicalIF":6.7000,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Allograft versus autograft ACL reconstruction in skeletally immature patients: a systematic review.\",\"authors\":\"Filippo Migliorini, Marco Pilone, Luise Schäfer, Francesca Alzira Bertini, Riccardo Giorgino, Nicola Maffulli\",\"doi\":\"10.1093/bmb/ldae020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Anterior cruciate ligament (ACL) injuries in children and adolescents with open physes are common.</p><p><strong>Areas of agreement: </strong>Evidence of ACL reconstruction using allografts in children with open physes is limited.</p><p><strong>Areas of controversy: </strong>Whether the outcomes of ACL allograft reconstruction in children and adolescents with open physes are superior to autograft ACL reconstruction is unclear, with contrasting evidence.</p><p><strong>Source of data: </strong>In October 2024, the Web of Science, PubMed, and Embase were accessed with no additional filters. Only clinical investigations evaluating ACL reconstruction in children or adolescents with open physes were eligible. Only studies reporting a minimum length of 24 months of follow-up were included.</p><p><strong>Areas timely for developing research: </strong>Children who undergo allograft ACL reconstruction demonstrate similar functional outcomes to those who undergo autograft ACL reconstruction. Although allografts allow a faster return to sport, the greater laxity, the reduced activity level, and the higher failure and reoperation rates make their use dubious as a first-choice option for ACL reconstruction in skeletally immature patients.</p>\",\"PeriodicalId\":9280,\"journal\":{\"name\":\"British medical bulletin\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.7000,\"publicationDate\":\"2024-12-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British medical bulletin\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/bmb/ldae020\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British medical bulletin","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bmb/ldae020","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
前言：前交叉韧带（ACL）损伤在儿童和青少年开放的物理是常见的。一致的领域：使用同种异体移植物重建开放性肢体儿童前交叉韧带的证据有限。争议领域：对于开放性骨折的儿童和青少年，同种异体前交叉韧带移植重建的结果是否优于自体前交叉韧带移植重建尚不清楚。数据来源：在2024年10月，Web of Science、PubMed和Embase在没有额外过滤器的情况下被访问。只有评估开放性肢体的儿童或青少年ACL重建的临床研究才符合条件。只纳入了随访时间至少为24个月的研究。及时开展研究的领域：接受同种异体ACL重建的儿童与接受自体ACL重建的儿童表现出相似的功能结果。尽管同种异体移植物可以更快地恢复运动，但更大的松弛性、更低的活动水平、更高的失败率和再手术率使其作为骨骼不成熟患者前交叉韧带重建的第一选择受到质疑。
Allograft versus autograft ACL reconstruction in skeletally immature patients: a systematic review.
Introduction: Anterior cruciate ligament (ACL) injuries in children and adolescents with open physes are common.
Areas of agreement: Evidence of ACL reconstruction using allografts in children with open physes is limited.
Areas of controversy: Whether the outcomes of ACL allograft reconstruction in children and adolescents with open physes are superior to autograft ACL reconstruction is unclear, with contrasting evidence.
Source of data: In October 2024, the Web of Science, PubMed, and Embase were accessed with no additional filters. Only clinical investigations evaluating ACL reconstruction in children or adolescents with open physes were eligible. Only studies reporting a minimum length of 24 months of follow-up were included.
Areas timely for developing research: Children who undergo allograft ACL reconstruction demonstrate similar functional outcomes to those who undergo autograft ACL reconstruction. Although allografts allow a faster return to sport, the greater laxity, the reduced activity level, and the higher failure and reoperation rates make their use dubious as a first-choice option for ACL reconstruction in skeletally immature patients.
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British Medical Bulletin is a multidisciplinary publication, which comprises high quality reviews aimed at generalist physicians, junior doctors, and medical students in both developed and developing countries.
Its key aims are to provide interpretations of growing points in medicine by trusted experts in the field, and to assist practitioners in incorporating not just evidence but new conceptual ways of thinking into their practice.
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