同种异体肌腱重建膝关节前交叉韧带的研究进展与临床应用
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摘要
背景:同种异体移植物在膝关节前交叉韧带重建的相关基础及临床实践中有着积极的推动作用与重要地位。目的:归纳总结近年来同种异体移植物在膝关节前交叉韧带重建中的应用及研究进展。方法:以"allograft tends OR allografts、intra-articular knee ligament OR anterior cruciate ligament OR ACL"为检索词,检索2012年1月至2018年2月PubMed、Embase等数据库中发表的相关文献,语言设定为英文。结果与结论:国内膝关节前交叉韧带重建使用同种异体肌腱的相关研究目前仍处在发展阶段。目前,对于前交叉韧带重建中使用同种异体移植物或自体移植物的优劣暂无定论。对于选择同种异体移植物的担忧主要来源于可能存在感染及愈合缓慢等问题。对于同种异体移植及自体移植术后效果比较,不同试验得出的结果差异较大。所反映出的结论大致为:2种移植物术后患者膝关节功能无差异,或自体移植后患者膝关节功能较好。有研究表明,同种异体移植物可能会增高二次手术的风险。因此,同种异体肌腱在膝关节前交叉韧带重建的临床应用中面临着诸多挑战。
BACKGROUND: The use of allograft tendon promotes the development of anterior cruciate ligament reconstruction, which is of great importance in the relevant basic research and clinical practice. OBJECTIVE: To summarize the current application and progress of allograft tendon in the anterior cruciate ligament reconstruction. METHODS: We searched relevant articles about the use of allograft tendon in PubMed and Embase published from January 2012 to February 2018 using the keywords of "allograft tends OR allografts, intra-articular knee ligament OR anterior cruciate ligament OR ACL". RESULTS AND CONCLUSION: China's use of allogeneic tendon in the reconstruction of the anterior cruciate ligament is still in the developmental stage. The current pros and cons of using allografts or autografts in anterior cruciate ligament reconstruction are inconclusive. Concerns about the choice of allografts are mainly due to possible infections and slow healing. A huge difference exists in different trials concerning the effects of allografts versus autografts. The conclusions are therefore roughly as follows: there is no difference in knee function after implantation of the two grafts, or the knee joint function is better after autograft. Studies have shown that allografts may increase the risk of secondary surgery. Therefore, the use of allograft tendon faces many clinical challenges in the anterior cruciate ligament reconstruction.
BACKGROUND: The use of allograft tendon promotes the development of anterior cruciate ligament reconstruction, which is of great importance in the relevant basic research and clinical practice. OBJECTIVE: To summarize the current application and progress of allograft tendon in the anterior cruciate ligament reconstruction. METHODS: We searched relevant articles about the use of allograft tendon in PubMed and Embase published from January 2012 to February 2018 using the keywords of "allograft tends OR allografts, intra-articular knee ligament OR anterior cruciate ligament OR ACL". RESULTS AND CONCLUSION: China's use of allogeneic tendon in the reconstruction of the anterior cruciate ligament is still in the developmental stage. The current pros and cons of using allografts or autografts in anterior cruciate ligament reconstruction are inconclusive. Concerns about the choice of allografts are mainly due to possible infections and slow healing. A huge difference exists in different trials concerning the effects of allografts versus autografts. The conclusions are therefore roughly as follows: there is no difference in knee function after implantation of the two grafts, or the knee joint function is better after autograft. Studies have shown that allografts may increase the risk of secondary surgery. Therefore, the use of allograft tendon faces many clinical challenges in the anterior cruciate ligament reconstruction.
引文
[1]Guo L,Chen H,Luo JM,et al.An Arthroscopic Second-Look Study on the Effect of Remnant Preservation on Synovialization of Bone-Patellar Tendon-Bone Allograft in Anterior Cruciate Ligament Reconstruction.Arthroscopy.2016;32(5):868-877.
[2]Rice RS,Waterman BR,Lubowitz JH.Allograft versus autograft decision for anterior cruciate ligament reconstruction:an expected-value decision analysis evaluating hypothetical patients.Arthroscopy.2012;28(4):539-547.
[3]Chechik O,Amar E,Khashan M,et al.An international survey on anterior cruciate ligament reconstruction practices.Int Orthop.2013;37(2):201-206.
[4]Beyaz S,Ozkoc G,Akpinar S,et al.Comparison of tunnel expansion and isometric muscle strength after ACLreconstruction with single-or dual-bundle hamstring allograft:a prospective,randomized study.Acta Orthop Traumatol Turc.2012;46(5):353-360.
[5]Maletis GB,Chen J,Inacio MCS,et al.Increased Risk of Revision After Anterior Cruciate Ligament Reconstruction With Bone-Patellar Tendon-Bone Allografts Compared With Autografts.Am J Sports Med.2017;45(6):1333-1340.
[6]Buda R,Ruffilli A,Di Caprio F,et al.Allograft salvage procedure in multiple-revision anterior cruciate ligament reconstruction.Am J Sports Med.2013;41(2):402-410.
[7]Fanelli GC,Edson CJ.Surgical treatment of combined PCL-ACLmedial and lateral side injuries(global laxity):surgical technique and 2-to 18-year results.J Knee Surg.2012;25(4):307-316.
[8]Noh JH,Yoon KH,Kyung HS,et al.Multiple looping technique for tibial fixation in posterior cruciate ligament reconstruction using free tendon Achilles allograft.Knee Surg Sports Traumatol Arthrosc.2017;25(8):2640-2645.
[9]Tian S,Wang B,Liu L,et al.Irradiated Hamstring Tendon Allograft Versus Autograft for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction:Midterm Clinical Outcomes.Am J Sports Med.2016;44(10):2579-2588.
[10]Nelson IR,Chen J,Love R,et al.A comparison of revision and rerupture rates of ACL reconstruction between autografts and allografts in the skeletally immature.Knee Surg Sports Traumatol Arthrosc.2016;24(3):773-779.
[11]Baldini T,Caperton K,Hawkins M,et al.Effect of a novel sterilization method on biomechanical properties of soft tissue allograftsKnee Surg Sports Traumatol Arthrosc.2016;24(12):3971-3975.
[12]Camargo JF.Donor-derived infections in solid organ transplant recipients:Challenging the 30-day paradigm.Transpl Infect Dis.2017;19(2).doi:10.1111/tid.12665.Epub 2017 Mar 6.
[13]Whitlock PW,Seyler TM,Parks GD,et al.A novel process for optimizing musculoskeletal allograft tissue to improve safety,ultrastructural properties,and cell infiltration.J Bone Joint Surg Am.2012;94(16):1458-1467.
[14]Larson CM,Heikes CS,Ellingson CI,et al.Allograft and Autograft Transphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients:Outcomes and Complications.Arthroscopy.2016;32(5):860-867.
[15]Wei W,Liu Y,Yang X,et al.Fractionation of 50kGy electron beam irradiation:effects on biomechanics of human flexor digitorum superficialis tendons treated with ascorbate.JBiomech.2013;46(4):658-661.
[16]Yanke A,Bell R,Lee A,et al.Regional mechanical properties of human patellar tendon allografts.Knee Surg Sports Traumatol Arthrosc.2015;23(4):961-967.
[17]Okeagu CN,Baker EA,Barreras NA,et al.Review of Mechanical,Processing,and Immunologic Factors Associated With Outcomes of Fresh Osteochondral Allograft Transplantation of the Talus.Foot Ankle Int.2017;38(7):808-819.
[18]Li J,Kong F,Gao X,et al.Prospective Randomized Comparison of Knee Stability and Proprioception for Posterior Cruciate Ligament Reconstruction With Autograft,Hybrid Graft,and gamma-Irradiated Allograft.Arthroscopy.2016;32(12):2548-2555.
[19]Li J,Wang J,Li Y,et al.A Prospective Randomized Study of Anterior Cruciate Ligament Reconstruction With Autograft,gamma-Irradiated Allograft,and Hybrid Graft.Arthroscopy.2015;31(7):1296-1302.
[20]Kane PW,Wascher J,Dodson CC,et al.Anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft versus allograft in skeletally mature patients aged 25years or younger.Knee Surg Sports Traumatol Arthrosc.2016;24(11):3627-3633.
[21]Seo YJ,Yoo YS,Noh KC,et al.Dynamic function of coracoclavicular ligament at different shoulder abduction angles:a study using a 3-dimensional finite element model.Arthroscopy.2012;28(6):778-787.
[22]Sun R,Chen BC,Wang F,et al.Prospective randomized comparison of knee stability and joint degeneration for double-and single-bundle ACL reconstruction.Knee Surg Sports Traumatol Arthrosc.2015;23(4):1171-1178.
[23]Delcroix GJ,Kaimrajh DN,Baria D,et al.Histologic,biomechanical,and biological evaluation of fan-folded iliotibial band allografts for anterior cruciate ligament reconstruction.Arthroscopy.2013;29(4):756-765.
[24]Noh JH,Yang BG,Yi SR,et al.Single-bundle anterior cruciate ligament reconstruction in active young men using bone-tendon achilles allograft versus free tendon achilles allograft.Arthroscopy.2013;29(3):507-513.
[25]Mei X,Zhang Z,Yang J.Double-layer versus single-layer bone-patellar tendon-bone anterior cruciate ligament reconstruction:a prospective randomized study with 3-year follow-up.Arch Orthop Trauma Surg.2016;136(12):1733-1739.
[26]Dai C,Wang F,Wang X,et al.Arthroscopic single-bundle anterior cruciate ligament reconstruction with six-strand hamstring tendon allograft versus bone-patellar tendon-bone allograft.Knee Surg Sports Traumatol Arthrosc.2016;24(9):2915-2922.
[27]Sanders TL,Pareek A,Hewett TE,et al.Long-term rate of graft failure after ACL reconstruction:a geographic population cohort analysis.Knee Surg Sports Traumatol Arthrosc.2017;25(1):222-228.
[28]Sun K,Zhang J,Wang Y,et al.A prospective randomized comparison of irradiated and non-irradiated hamstring tendon allograft for ACL reconstruction.Knee Surg Sports Traumatol Arthrosc.2012;20(1):187-194.
[29]Zhao B,Ran X,Zhang M,et al.Surgical treatment of Segond fracture and complications.Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi.2013;27(9):1045-1049.
[30]Maletis GB,Inacio MC,Desmond JL,et al.Reconstruction of the anterior cruciate ligament:association of graft choice with increased risk of early revision.Bone Joint J.2013;95-B(5):623-628.
[31]Kim SH,Chun CH,Chun KC,et al.Histological assessment of mechanoreceptors in Achilles allografts after anterior cruciate ligament reconstruction.Am J Sports Med.2012;40(9):2061-2065.
[32]Cohen SB,Pandarinath R,O'Hagan T,et al.Results of ACLreconstruction with tibial Retroscrew fixation:Comparison of clinical outcomes and tibial tunnel widening.Phys Sportsmed.2015;43(2):138-142.
[33]Hoburg A,Keshlaf S,Schmidt T,et al.High-dose electron beam sterilization of soft-tissue grafts maintains significantly improved biomechanical properties compared to standard gamma treatment.Cell Tissue Bank.2015;16(2):219-226.
[34]Tian S,Ha C,Wang B,et al.Arthroscopic anatomic double-bundle ACL reconstruction using irradiated versus non-irradiated hamstring tendon allograft.Knee Surg Sports Traumatol Arthrosc.2017;25(1):251-259.
[35]Noh JH,Yang BG,Yi SR,et al.Hybrid tibial fixation for anterior cruciate ligament reconstruction with Achilles tendon allograft.Arthroscopy.2012;28(10):1540-1546.
[36]Qu J,Thoreson AR,An KN,et al.What is the best candidate allograft for ACL reconstruction?An in vitro mechanical and histologic study in a canine model.J Biomech.2015;48(10):1811-1816.
[2]Rice RS,Waterman BR,Lubowitz JH.Allograft versus autograft decision for anterior cruciate ligament reconstruction:an expected-value decision analysis evaluating hypothetical patients.Arthroscopy.2012;28(4):539-547.
[3]Chechik O,Amar E,Khashan M,et al.An international survey on anterior cruciate ligament reconstruction practices.Int Orthop.2013;37(2):201-206.
[4]Beyaz S,Ozkoc G,Akpinar S,et al.Comparison of tunnel expansion and isometric muscle strength after ACLreconstruction with single-or dual-bundle hamstring allograft:a prospective,randomized study.Acta Orthop Traumatol Turc.2012;46(5):353-360.
[5]Maletis GB,Chen J,Inacio MCS,et al.Increased Risk of Revision After Anterior Cruciate Ligament Reconstruction With Bone-Patellar Tendon-Bone Allografts Compared With Autografts.Am J Sports Med.2017;45(6):1333-1340.
[6]Buda R,Ruffilli A,Di Caprio F,et al.Allograft salvage procedure in multiple-revision anterior cruciate ligament reconstruction.Am J Sports Med.2013;41(2):402-410.
[7]Fanelli GC,Edson CJ.Surgical treatment of combined PCL-ACLmedial and lateral side injuries(global laxity):surgical technique and 2-to 18-year results.J Knee Surg.2012;25(4):307-316.
[8]Noh JH,Yoon KH,Kyung HS,et al.Multiple looping technique for tibial fixation in posterior cruciate ligament reconstruction using free tendon Achilles allograft.Knee Surg Sports Traumatol Arthrosc.2017;25(8):2640-2645.
[9]Tian S,Wang B,Liu L,et al.Irradiated Hamstring Tendon Allograft Versus Autograft for Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction:Midterm Clinical Outcomes.Am J Sports Med.2016;44(10):2579-2588.
[10]Nelson IR,Chen J,Love R,et al.A comparison of revision and rerupture rates of ACL reconstruction between autografts and allografts in the skeletally immature.Knee Surg Sports Traumatol Arthrosc.2016;24(3):773-779.
[11]Baldini T,Caperton K,Hawkins M,et al.Effect of a novel sterilization method on biomechanical properties of soft tissue allograftsKnee Surg Sports Traumatol Arthrosc.2016;24(12):3971-3975.
[12]Camargo JF.Donor-derived infections in solid organ transplant recipients:Challenging the 30-day paradigm.Transpl Infect Dis.2017;19(2).doi:10.1111/tid.12665.Epub 2017 Mar 6.
[13]Whitlock PW,Seyler TM,Parks GD,et al.A novel process for optimizing musculoskeletal allograft tissue to improve safety,ultrastructural properties,and cell infiltration.J Bone Joint Surg Am.2012;94(16):1458-1467.
[14]Larson CM,Heikes CS,Ellingson CI,et al.Allograft and Autograft Transphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients:Outcomes and Complications.Arthroscopy.2016;32(5):860-867.
[15]Wei W,Liu Y,Yang X,et al.Fractionation of 50kGy electron beam irradiation:effects on biomechanics of human flexor digitorum superficialis tendons treated with ascorbate.JBiomech.2013;46(4):658-661.
[16]Yanke A,Bell R,Lee A,et al.Regional mechanical properties of human patellar tendon allografts.Knee Surg Sports Traumatol Arthrosc.2015;23(4):961-967.
[17]Okeagu CN,Baker EA,Barreras NA,et al.Review of Mechanical,Processing,and Immunologic Factors Associated With Outcomes of Fresh Osteochondral Allograft Transplantation of the Talus.Foot Ankle Int.2017;38(7):808-819.
[18]Li J,Kong F,Gao X,et al.Prospective Randomized Comparison of Knee Stability and Proprioception for Posterior Cruciate Ligament Reconstruction With Autograft,Hybrid Graft,and gamma-Irradiated Allograft.Arthroscopy.2016;32(12):2548-2555.
[19]Li J,Wang J,Li Y,et al.A Prospective Randomized Study of Anterior Cruciate Ligament Reconstruction With Autograft,gamma-Irradiated Allograft,and Hybrid Graft.Arthroscopy.2015;31(7):1296-1302.
[20]Kane PW,Wascher J,Dodson CC,et al.Anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft versus allograft in skeletally mature patients aged 25years or younger.Knee Surg Sports Traumatol Arthrosc.2016;24(11):3627-3633.
[21]Seo YJ,Yoo YS,Noh KC,et al.Dynamic function of coracoclavicular ligament at different shoulder abduction angles:a study using a 3-dimensional finite element model.Arthroscopy.2012;28(6):778-787.
[22]Sun R,Chen BC,Wang F,et al.Prospective randomized comparison of knee stability and joint degeneration for double-and single-bundle ACL reconstruction.Knee Surg Sports Traumatol Arthrosc.2015;23(4):1171-1178.
[23]Delcroix GJ,Kaimrajh DN,Baria D,et al.Histologic,biomechanical,and biological evaluation of fan-folded iliotibial band allografts for anterior cruciate ligament reconstruction.Arthroscopy.2013;29(4):756-765.
[24]Noh JH,Yang BG,Yi SR,et al.Single-bundle anterior cruciate ligament reconstruction in active young men using bone-tendon achilles allograft versus free tendon achilles allograft.Arthroscopy.2013;29(3):507-513.
[25]Mei X,Zhang Z,Yang J.Double-layer versus single-layer bone-patellar tendon-bone anterior cruciate ligament reconstruction:a prospective randomized study with 3-year follow-up.Arch Orthop Trauma Surg.2016;136(12):1733-1739.
[26]Dai C,Wang F,Wang X,et al.Arthroscopic single-bundle anterior cruciate ligament reconstruction with six-strand hamstring tendon allograft versus bone-patellar tendon-bone allograft.Knee Surg Sports Traumatol Arthrosc.2016;24(9):2915-2922.
[27]Sanders TL,Pareek A,Hewett TE,et al.Long-term rate of graft failure after ACL reconstruction:a geographic population cohort analysis.Knee Surg Sports Traumatol Arthrosc.2017;25(1):222-228.
[28]Sun K,Zhang J,Wang Y,et al.A prospective randomized comparison of irradiated and non-irradiated hamstring tendon allograft for ACL reconstruction.Knee Surg Sports Traumatol Arthrosc.2012;20(1):187-194.
[29]Zhao B,Ran X,Zhang M,et al.Surgical treatment of Segond fracture and complications.Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi.2013;27(9):1045-1049.
[30]Maletis GB,Inacio MC,Desmond JL,et al.Reconstruction of the anterior cruciate ligament:association of graft choice with increased risk of early revision.Bone Joint J.2013;95-B(5):623-628.
[31]Kim SH,Chun CH,Chun KC,et al.Histological assessment of mechanoreceptors in Achilles allografts after anterior cruciate ligament reconstruction.Am J Sports Med.2012;40(9):2061-2065.
[32]Cohen SB,Pandarinath R,O'Hagan T,et al.Results of ACLreconstruction with tibial Retroscrew fixation:Comparison of clinical outcomes and tibial tunnel widening.Phys Sportsmed.2015;43(2):138-142.
[33]Hoburg A,Keshlaf S,Schmidt T,et al.High-dose electron beam sterilization of soft-tissue grafts maintains significantly improved biomechanical properties compared to standard gamma treatment.Cell Tissue Bank.2015;16(2):219-226.
[34]Tian S,Ha C,Wang B,et al.Arthroscopic anatomic double-bundle ACL reconstruction using irradiated versus non-irradiated hamstring tendon allograft.Knee Surg Sports Traumatol Arthrosc.2017;25(1):251-259.
[35]Noh JH,Yang BG,Yi SR,et al.Hybrid tibial fixation for anterior cruciate ligament reconstruction with Achilles tendon allograft.Arthroscopy.2012;28(10):1540-1546.
[36]Qu J,Thoreson AR,An KN,et al.What is the best candidate allograft for ACL reconstruction?An in vitro mechanical and histologic study in a canine model.J Biomech.2015;48(10):1811-1816.