中国组织工程研究

中国组织工程研究 ›› 2014, Vol. 18 ›› Issue (42): 6863-6870.doi: 10.3969/j.issn.2095-4344.2014.42.026

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    下一篇

自体与非放射线处理同种异体肌腱重建前交叉韧带的荟萃分析

王伊伦，谢东兴，李  辉，杨  拓，邓桢翰，杨  烨，张  屹，丁  翔，雷光华   

  1. 中南大学湘雅医院骨科，湖南省长沙市  410008
  • 修回日期:2014-08-20 出版日期:2014-10-08 发布日期:2014-10-08
  • 通讯作者: 雷光华，博士，教授，主任医师，博士生导师，中南大学湘雅医院骨科，湖南省长沙市 410008
  • 作者简介:王伊伦，男，1991年生，湖南省长沙市人，汉族，中南大学湘雅医院骨科在读硕士，主要从事关节外科方面的研究。
  • 基金资助:

    国家自然科学基金项目(81272034)；湖南省发改委项目([2013]1199)；湖南省科技厅科研项目(2013SK2018)；教育部博士点基金(20120162110036)

Autograft versus non-irradiated allograft for anterior cruciate ligament reconstruction: a meta-analysis

Wang Yi-lun, Xie Dong-xing, Li Hui, Yang Tuo, Deng Zhen-han, Yang Ye, Zhang Yi, Ding Xiang, Lei Guang-hua   

  1. Department of Orthopedics, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
  • Revised:2014-08-20 Online:2014-10-08 Published:2014-10-08
  • Contact: Lei Guang-hua, M.D., Professor, Chief physician, Doctoral supervisor, Department of Orthopedics, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
  • About author:Wang Yi-lun, Studying for master’s degree, Department of Orthopedics, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81272034; grant from Development and Reform Commission of Hunan Province, No. [2013]1199; the Science and Technology Program of Hunan Provincial Science and Technology Bureau, No. 2013SK2018; Doctoral Fund of Ministry of Education of China, No. 20120162110036

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766

被引次数

2

摘要：

背景：当今，前交叉韧带重建是修复膝关节前交叉韧带损伤的常用方法，但就重建移植物的选择问题尚存在不少争议。
目的：比较自体与非放射线处理的同种异体肌腱移植重建前交叉韧带临床疗效的差异。
方法：计算机检索PubMed/Medline数据库以及手工检索国内外公开发表的有关自体与非放射线处理的同种异体肌腱移植重建前交叉韧带的随机对照试验，所有文献检索截止至2014年7月12日。应用RevMan5.2软件进行数据统计分析，输入数据时采取双人核对以确保准确无误。
结果与结论：共纳入6项随机对照试验，累计858例受试对象，其中自体肌腱组441例，非放射线处理的同种异体肌腱组417例。荟萃分析结果显示，自体与非放射性处理的同种异体肌腱移植重建前交叉韧带的总IKDC评分[相对危险度=1.02，95%置信区间(0.99-1.06)，P=0.21]；松弛度[均数差=-0.13，95%置信区间(-0.29至-0.02)，P=0.09]；Lachman试验[相对危险度=1.04，95%置信区间(0.95-1.13)，P=0.37]；pivot shift试验[相对危险度=1.00，95%置信区间(0.95-1.05)，P=0.96]；one-leg hop试验[相对危险度=1.01，95%置信区间(0.96-1.06)，P=0.77]；Lysholm评分[均数差=-0.64，95%置信区间(-1.45-0.17)，P=0.12]；Tegner评分[均数差=0.16，95%置信区间(-0.16-0.47)，P=0.34]以及并发症发生率[相对危险度=1.42，95%置信区间(0.67-3.04)，P=0.36]的差异无显著性意义。以上结果表明，自体与非放射线处理的同种异体肌腱移植重建前交叉韧带的临床疗效并无明显差异，但鉴于此研究存在一定局限性，此结论有待更多更高质量的随机对照试验进一步证实。



中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程


全文链接：

关键词: 组织构建, 组织工程, 前交叉韧带重建, 自体肌腱, 异体肌腱, 非放射线处理, 荟萃分析, 国家自然科学基金

Abstract:

BACKGROUND: Reconstruction of the anterior cruciate ligament has become the gold-standard treatment for an anterior cruciate ligament rupture. Despite the popularity of the procedure, there remains a considerable amount of controversies over whether an autograft or anallograft should be used for primary anterior cruciate ligament reconstruction.
OBJECTIVE: To compare the clinical outcomes of allograft and autograft in primary anterior cruciate ligament reconstruction.
METHODS: Randomized controlled trials concerning autograft versus non-irradiated allograft for anterior cruciate ligament reconstruction were identified from the PubMed/Medline database conducted up to July 12, 2014. These studies were selected independently by two reviewers according to the inclusion and exclusion criteria. Meta-analysis was performed using Revman5.2 software.
RESULTS AND CONCLUSION: A total of 6 randomized controlled trials consisting of 858 cases were included, 441 cases in autograft group and 417 cases in non-irradiated allograft. The results of the meta-analysis indicate no significant difference between autografts and non-irradiated allografts in overall IKDC [relative risk (RR)=1.02, 95% confidence interval (CI) (0.99 to 1.06), P=0.21], degree of laxity [mean difference (MD)=-0.13, 95% CI (-0.29 to -0.02), P=0.09], Lachman test [RR=1.04, 95% CI (0.95 to 1.13), P=0.37], pivot shift test [RR=1.00, 95% CI (0.95 to 1.05),P=0.96], one-leg hop test [RR=1.01, 95% CI (0.96 to 1.06), P=0.77], Lysholm score [MD=-0.64, 95% CI (-1.45 to 0.17), P=0.12], Tegner score [MD=0.16, 95% CI (-0.16 to 0.47), P=0.34] and rate of postoperative complications [RR=1.42, 95% CI (0.67 to 3.04), P=0.36]. Therefore, in the meta-analysis, there is no significant difference between autograft and non-irradiated allograft in clinical outcomes. However due to the limitations of our study, further work is needed to determine this conclusion.



中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程


全文链接：

Key words: anterior cruciate ligament, tendons, transplantation, autologous, transplantation, homologous, evidence-based medicine

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