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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >5 Year Survival of Endoscopic ACL Reconstruction with Live Donor Hamstring Tendon Allograft in Juveniles and Adolescents
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5 Year Survival of Endoscopic ACL Reconstruction with Live Donor Hamstring Tendon Allograft in Juveniles and Adolescents

机译：活体供体Ham绳肌腱同种异体移植在青少年内窥镜ACL重建的5年生存率

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Introduction: ACL reconstruction with autografts in the young is associated a higher incidence of repeat injury when compared to adults. This led the authors to consider alternative graft material for the ACL deficient young population. This study was performed to assess the survival of ACL reconstruction with a living related hamstring tendon autograft in a large series of juveniles and adolescents. Aim: To determine the survival of the ACL graft and the contralateral ACL (CACL) after primary ACL reconstruction with living donor allograft in patients aged < 18 years and to identify the factors that increase the odds of subsequent ACL injuries. Methods: Patients having undergone primary ACL reconstruction with a living donor hamstring tendon allograft at age <18 years between 2005 and 2014 included in a prospective database were considered for this study. Patients completed a subjective survey involving the International Knee Documentation Committee (IKDC) questionnaire in addition to questions regarding current symptoms, further ACL injuries, family history of ACL injury, and current level of activity. Results: A total of 218 adolescents (mean age 14.7, age range, 8-17 years) met the inclusion criteria and were reviewed at a mean of 48 months after surgery. Of these, there were 51 ACL graft ruptures (23%) and 26 contralateral ACL ruptures (12%). The 1, 2 and 5 year survival of the ACL graft was 88%, 80% and 74%. The 1, 2 and 5 year survival of the contralateral ACL was 99%, 93% and 85%. Survival of the ACL graft was more favorable in those with open growth plates (93, 90, 85 at 1,2 and 5 survival) compared to closed growth plates (86, 75, 68 at 1,2 and 5 year survival), odds ratio 2.3 (95% CI 1.1 to 4.8, p=0.03). A return to preinjury level of activity was reported by 79%, and the mean IKDC score was 92 of a possible 100. A positive family history of ACL injury was present in 35%. Conclusion: Further injury after ACL reconstruction in the young presents a challenging problem. ACL reconstruction using a living related donor allograft is associated with high rates of return to sport and good subjective outcomes. This technique may be considered a viable option for ACL reconstruction in the young patient with open growth plates, but does not appear to reduce further injury in older adolescents.
机译：简介：与成人相比，年轻人自体移植重建ACL与重复损伤的发生率更高。这导致作者考虑为ACL缺乏的年轻人群使用替代移植材料。这项研究的目的是评估生活相关的绳肌腱自体移植在许多青少年中的ACL重建的存活率。目的：确定在年龄小于18岁的患者中进行活体供体同种异体原发性ACL重建后，ACL移植物和对侧ACL（CACL）的存活率，并确定增加后续ACL损伤几率的因素。方法：将2005年至2014年间年龄<18岁的活体供体donor绳肌腱同种异体移植接受原发性ACL重建的患者纳入本研究。除有关当前症状，进一步的ACL损伤，ACL损伤家族史和当前活动水平的问题外，患者还完成了涉及国际膝关节文献委员会（IKDC）问卷的主观调查。结果：总共218名青少年（平均年龄14.7，年龄范围，8-17岁）符合纳入标准，并且在术后48个月进行了平均检查。其中，有51例ACL移植物破裂（23％）和26例对侧ACL破裂（12％）。 ACL移植物的1年，2年和5年生存率分别为88％，80％和74％。对侧ACL的1、2和5年生存率分别为99％，93％和85％。与封闭生长板（分别在1,2和5年生存时分别为86、75、68和1,2,5年生存率）相比，开放生长板（分别在1,2和5年生存率分别为93、90、85和93）的ACL移植物的存活率更高。比率2.3（95％CI 1.1到4.8，p = 0.03）。据报道，损伤前的活动水平恢复了79％，平均IKDC评分为100（可能为100）中的92。ACL损伤的阳性家族史为35％。结论：年轻人ACL重建后的进一步损伤是一个具有挑战性的问题。使用与生活有关的供体同种异体移植进行ACL重建与高回报运动率和良好的主观结果相关。这项技术可能被认为是在生长板开放的年轻患者中进行ACL重建的可行选择，但似乎并未减少年长青少年的进一步伤害。

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