结合ACL和ALL重建使用异位移植作为ACL移植来源减少了手术失败并改善了与孤立ACL重建相比的移植成熟度
Hyun-Soo Moon1,2, Sungjun Kim3, Min Jung1,4
1Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Journal of clinical medicine
|January 28, 2026
概括
将前侧带 (ALL) 重建添加到前交叉带 (ACL) 重建中,使用全移植显著降低了手术失败率,并与孤立的ACL手术相比改善了移植成熟度.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学 运动医学
- 生物机械工程 生物机械工程
背景情况:
- 前十字带 (ACL) 损伤通常会与相关的损伤发生,例如前侧带 (ALL) 撕裂.
- 孤立的ACL重建可能无法完全恢复膝盖的稳定性,可能导致移植失败.
- 同时的ALL重建在改善ACL重建结果中的作用需要进一步调查.
研究的目的:
- 为了比较结合ACL和ALL重建的外科结果与使用allografts的孤立ACL重建.
- 评估两种手术技术之间的临床结果,膝盖稳定性和放射性参数.
- 评估在接受联合与单独ACL重建的患者中手术失败的发生率.
主要方法:
- 进行了解剖学ACL重建的患者与或没有ALL重建 (2017-2023) 的匹配比较.
- 最少2年的随访时间,对混因子进行治疗权重的逆概率 (IPTW) 调整.
- 基线特征,功能结果,膝盖松和放射性参数的比较.
主要成果:
- 结合ACL和ALL重建显示,手术失败的发生率显著降低 (p=0.044在IPTW前,p=0.049在IPTW后).
- 在组合组中,ACL移植信号对噪声系数明显较低,表明移植成熟度更好 (p=0.046在IPTW前,p=0.038在IPTW后).
- 在IPTW调整后,手术后的功能结果和膝盖稳定性在组之间是可比的.
结论:
- 结合ACL和ALL重建与异位移植导致优异的结果与孤立的ACL重建相比.
- 添加ALL重建改善了移植成熟度,并降低了手术失败率.
- 同时的ALL重建应考虑在合移植ACL重建中,以增强膝盖稳定性和长期结果.
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