Hamstring autografts demonstrate either similar or inferior outcomes to quadriceps or bone-patellar tendon-bone autografts in revision anterior cruciate ligament reconstruction: A systematic review of comparative studies.

Autor: Vivekanantha P; Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada., Kahlon H; Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada., Hassan Z; Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada., Slawaska-Eng D; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada., Abdel-Khalik H; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada., Johnson J; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada., de Sa D; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2024 Jul 17. Date of Electronic Publication: 2024 Jul 17.
DOI: 10.1002/ksa.12366
Abstrakt: Purpose: To evaluate the clinical outcomes in patients undergoing revision anterior cruciate ligament reconstruction (r-ACLR) using hamstring tendon (HT) autografts with those using either quadriceps tendon (QT) or bone-patellar tendon-bone (BPTB) autografts or allografts.
Methods: Three databases were searched on 8 August 2023. The authors adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Data on demographics, surgical details, patient-reported outcome measures (PROMs), rates of instability, failure and return to sport (RTS) were extracted.
Results: Eleven studies comprising 859 patients were included in this review. Five studies compared HT and QT autografts. One study each reported greater IKDC scores (p = 0.04) and Tegner scores (p = 0.04) in the QT group, while one study each reported higher anterior translation (p = 0.04), rates of positive pivot shift (p = 0.03) and rates of failure (p = 0.03) in the HT group. Six studies compared HT and BPTB autografts with one study each reporting greater Lysholm scores (p = 0.02) and less side-to-side anterior laxity (p < 0.01) in the BPTB group. Two studies compared HT autografts with allografts with only one study reporting a faster time to RTS in the HT group than the allograft group (p < 0.001). All other comparisons were not significant.
Conclusions: HT autografts result in either similar or inferior outcomes in r-ACLR when compared to QT or BPTB autograft options. Allografts resulted in similar outcomes to HT autografts apart from greater time to RTS for r-ACLR.
Level of Evidence: Level III.
(© 2024 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)
Databáze: MEDLINE
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