中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (21): 5605-5613.doi: 10.12307/2026.769

• 植入物相关大数据分析 Implant related big data analysis • 上一篇    下一篇

膝关节前交叉韧带损伤重建后有效性和安全性评价标准的动态演变

李成科1，高苗苗1，雷  蕾1，马荣星2，张净宇1，胡永成1
  

  1. 1天津大学天津医院，天津市  300211；2天津医科大学，天津市  300211
  • 出版日期:2026-07-28 发布日期:2026-03-06
  • 通讯作者: 胡永成，博士，主任医师，天津大学天津医院，天津市 300211
  • 作者简介:李成科，男，1999年生，湖南省衡东县人，汉族，天津大学在读硕士，主要从事膝关节、骨与软组织肿瘤疾病方面的研究。
  • 基金资助:
    京津冀基础研究合作专项(22JCZXJC00130)，项目负责人：张净宇；天津市计量科技项目(2024TJMT039)，项目负责人：张净宇；天津市天津医院科技基金项目(TJYY2401)，项目参与人：张净宇；天津市卫生健康委员会科技项目(TJWJ2024MS027)，项目参与人：张净宇

Dynamic evolution of evaluation standards for effectiveness and safety after anterior cruciate ligament reconstruction in the knee

Li Chengke1, Gao Miaomiao1, Lei Lei1, Ma Rongxing2, Zhang Jingyu1, Hu Yongcheng1   

  1. 1Tianjin Hospital of Tianjin University, Tianjin 300211, China; 2Tianjin Medical University, Tianjin 300211, China

  • Online:2026-07-28 Published:2026-03-06
  • Contact: Hu Yongcheng, MD, Chief physician, Tianjin Hospital of Tianjin University, Tianjin 300211, China
  • About author:Li Chengke, MS candidate, Tianjin Hospital of Tianjin University, Tianjin 300211, China
  • Supported by:
    Beijing-Tianjin-Hebei Basic Research Cooperation Special Fund, No. 22JCZXJC00130 (to ZJY); Science and Technology Project of Tianjin Metrology Bureau, No. 2024TJMT039 (to ZJY); Tianjin Hospital Science and Technology Fund, No. TJYY2401 (to ZJY); Science and Technology Project of Tianjin Health Commission, No. TJWJ2024MS027 (to ZJY)

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摘要：

文题释义：

前交叉韧带重建：是治疗前交叉韧带断裂的标准外科方法，通过自体或同种异体移植物重建受损韧带以恢复膝关节前向稳定性和旋转控制。前交叉韧带重建不仅是韧带解剖学重建，更是关乎运动功能、生活质量及远期安全性的综合性手术，其疗效评价需结合主观与客观指标的动态演变加以分析。
主观评价标准：又叫患者报告结果测量，通过量表形式直接反映患者对膝关节功能与生活质量的感受。在此次研究纳入的主观评分量表中，Lysholm评分、Tegner活动评分、国际膝关节文献委员会主观膝关节评分和膝关节损伤和骨关节炎结局评分等是主要代表。自2005年起，主观评分的使用频率快速上升，并在2009年后超过客观评价标准，占比超过一半，反映了临床评价由关注结构稳定性逐渐转向以患者体验为中心的趋势。

摘要
背景：通常需要将主观评分和客观评价标准联合使用才能更准确和全面地对前交叉韧带损伤重建患者的膝关节功能进行评估。
目的：回顾前交叉韧带重建后有效性和安全性评价标准的演变趋势，分析主观与客观测量工具使用的动态演变。
方法：对PubMed与Embase数据库进行了系统性检索，检索时限为建库至2023-08-22，识别包含前交叉韧带重建后评估膝关节功能的研究，最终筛选符合纳入标准的研究文献共136篇，提取文中使用的各类评价标准的使用频率，最后运用Origin 2025软件分析其随时间的变化。
结果与结论：①在1990-2005年间，客观评价标准应用较为广泛；自2005年起，以患者报告结果测量为代表的主观评分的使用比例迅速上升，且于2009年起使用频率显著超过客观评价标准；②其中早期以Lysholm量表、Tegner活动评分占主导地位，后期国际膝关节文献委员会主观膝关节评分、膝关节损伤和骨关节炎结局评分及前交叉韧带受伤后恢复运动量表逐渐成为主要主观工具；③此外，在客观评价方面，KT1000/2000 关节测量仪、Lachman试验和跳跃试验的应用保持相对稳定，但总体处于下降趋势；④提示前交叉韧带重建后有效性和安全性评估标准经历了从以客观膝关节稳定性为主向以患者主观体验为中心的转变；⑤此文首次通过量化数据揭示当今主流评价工具的动态演变过程，指出当前临床实践强调主客观评价标准结合评估，推荐的组合为：国际膝关节文献委员会主观膝关节评分或膝关节损伤和骨关节炎结局评分 + 前交叉韧带受伤后恢复运动量表 + KT1000/2000或跳跃试验，以全面反映膝关节功能恢复与患者感知结果，为未来建立综合评估方式提供了实证基础。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 前交叉韧带损伤, 前交叉韧带重建, 主观评价标准, 客观评价标准, 动态演变, 趋势分析

Abstract: BACKGROUND: A combination of subjective and objective evaluation criteria is often required to more accurately and comprehensively assess knee function in patients undergoing anterior cruciate ligament reconstruction.
OBJECTIVE: To review the evolving trends in effectiveness and safety evaluation criteria after anterior cruciate ligament reconstruction and analyze the dynamic shift in the use of subjective and objective assessment tools.
METHODS: A systematic search of PubMed and Embase was conducted up to August 22, 2023 to identify studies assessing knee function after anterior cruciate ligament reconstruction. A total of 136 eligible studies meeting the inclusion criteria were included. The frequency of each evaluation standard was extracted and analyzed over time using Origin 2025 software.
RESULTS AND CONCLUSION: (1) Between 1990 and 2005, objective measures were widely applied. Since 2005, subjective scoring systems, particularly patient-reported outcome measures, have increased sharply, surpassing objective standards in frequency from 2009 onward. (2) Early use was dominated by the Lysholm scale and Tegner activity score, while the International Knee Documentation Committee-Subjective Knee Form, Knee Injury and Osteoarthritis Outcome Score, and anterior cruciate ligament–return to sport after injury gradually emerged as the main tools in later years. (3) In contrast, objective assessments such as the KT1000/2000 arthrometer, Lachman test, and hop tests remained relatively stable but showed an overall downward trend. (4) This suggests that the evaluation criteria for the effectiveness and safety of anterior cruciate ligament reconstruction have shifted from a primary focus on objective knee stability to an emphasis on patient-reported experiences. (5) This study is the first to quantitatively reveal the dynamic evolution of mainstream assessment tools. Current clinical practice highlights the integration of subjective and objective measures, and we recommend the following combination: International Knee Documentation Committee-Subjective Knee Form or Knee Injury and Osteoarthritis Outcome Score, together with anterior cruciate ligament–return to sport after injury, plus either the KT1000/2000 arthrometer or hop tests. Such a framework provides a more comprehensive reflection of both functional recovery and patient perception, offering an evidence-based foundation for the development of future integrated evaluation systems.

Key words: ">anterior cruciate ligament injury, anterior cruciate ligament reconstruction, subjective evaluation criteria, objective evaluation criteria, dynamic evolution, trend analysis

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