Background:

Hamstring tendon autografts are commonly used for primary anterior cruciate ligament (ACL) reconstruction. Some patients have small hamstring tendons however, which may compromise the clinical outcome of the autograft. To solve this problem, many surgeons use hybrid grafting that involves augmentation of small hamstring autografts with allograft tissue.

Purpose/Hypothesis:

The purpose was to compare the clinical outcomes between primary ACL reconstructions performed with hamstring autografts and those performed with hybrid grafts in terms of patient-reported evaluation, failure rate, and knee stability. The hypothesis was that primary ACL reconstruction performed with hamstring autograft alone will not differ significantly from that performed with a hybrid graft in terms of patient-reported evaluation, failure rate, or knee stability.

Study Design:

Systematic review.

Methods:

A systematic review was performed to identify prospective and retrospective comparative studies and cohort studies (evidence levels 1-3) comparing outcomes of primary ACL reconstructions performed with hamstring autografting alone and hybrid grafting. Outcomes included patient-reported evaluation, failure rate, and knee stability.

Results:

Ten studies were included: 1 of level 2 and 9 of level 3. Collectively, they included 398 autografts and 341 hybrid grafts. Mean respective follow-up durations ranged from 24.0 to 69.6 months and from 24.0 to 70.8 months. Patient-reported evaluations, including Lysholm, Tegner, and subjective International Knee Documentation Committee scores, were reported in 8 of 10 studies. Failure rates were reported in all 10 studies. Results of knee stability examinations—including KT-1000 arthrometer measurements, the pivot-shift test, Lachman test, and overall International Knee Documentation Committee results—were reported in 4 of 10 studies. In this review, there were no statistically significant differences between autografts and hybrid grafts in terms of patient-reported evaluations, failure rates, or KT-1000 measurements.

Conclusion:

In this systematic review, there was no significant difference in patient-reported evaluation or failure rate between primary ACL reconstructions performed with autografts alone and those performed with hybrid grafts. Whether there is a substantial difference in knee stability examination results between autografts and hybrid grafts remains unknown, given a relative lack of reports on knee stability.

中文翻译：

---

绳肌自体移植物与杂交移植重建前交叉韧带：系统评价。

背景：

绳肌腱自体移植通常用于原发性前交叉韧带（ACL）重建。但是，有些患者的绳肌腱较小，可能会损害自体移植的临床效果。为了解决这个问题，许多外科医生使用混合移植，其中包括用同种异体移植组织扩大小腿筋自体移植。

目的/假设：

目的是比较就患者报告的评估，失败率和膝关节稳定性而言，用绳肌自体移植进行的初次ACL重建与混合移植进行的临床结局。该假设是，就患者报告的评估，失败率或膝关节稳定性而言，仅使用string绳肌自体移植进行的一次ACL重建与使用混合移植进行的ACL重建没有显着差异。

学习规划：

系统评价。

方法：

进行了系统的回顾，以鉴定前瞻性和回顾性比较研究以及队列研究（证据水平1-3），比较单独使用绳肌自体移植和杂交移植进行的初次ACL重建的结果。结果包括患者报告的评估，失败率和膝盖稳定性。

结果：

包括十项研究：1级为2级，9级为3级。总共包括398例自体移植物和341例杂种移植物。平均相应的随访时间为24.0至69.6个月和24.0至70.8个月。在10项研究中的8项中报告了患者报告的评估，包括Lysholm，Tegner和主观国际膝关节文献委员会评分。在所有10项研究中均报告了失败率。在10项研究中，有4项报告了膝关节稳定性检查的结果，包括KT-1000关节流量计的测量，枢轴位移测试，Lachman测试以及国际膝关节文献委员会的总体结果。在该评价中，就患者报告的评估，失败率或KT-1000测量而言，自体移植物和杂种移植物之间在统计学上没有显着差异。

结论：

在这项系统评价中，单独使用自体移植进行的初次ACL重建与采用混合移植进行的初次ACL重建之间，患者报告的评估或失败率没有显着差异。鉴于相对缺乏关于膝关节稳定性的报道，自体移植物和混合移植物之间在膝关节稳定性检查结果上是否存在实质性差异仍然未知。