前交叉韧带重建移植物选择的研究进展

doi:10.3969/j.issn.2095-378X.2023.02.013

摘要/Abstract

摘要： 前交叉韧带（anterior cruciate ligament, ACL）是膝关节内重要的前向稳定结构,同时也是运动中最易损伤结构之一。ACL损伤会限制患者运动功能,如不能及时治疗,常继发半月板、关节软骨损伤,甚至创伤性骨关节炎等严重并发症。目前,ACL重建是目前ACL损伤标准治疗方式,而移植物选择对患者术后功能恢复和手术成功率具有重要影响。自体移植物是目前最常用的移植物,且疗效最为稳定,但存在来源有限与取腱并发症等缺点。异体移植物适用性更广,但又带来疾病传播与免疫排斥的风险。人工韧带适用于急需重返运动人群,但技术难度高,且缺乏长期有效性报道。因此,传统移植物存在诸多问题,近年来快速发展的组织工程技术正为ACL重建提供新思路。本文综述了ACL重建中各种移植物优缺点与临床疗效,以期为ACL损伤的治疗提供帮助。

关键词: 膝关节, 前交叉韧带, 移植物, 腘绳肌腱, 组织工程, 重建

Abstract: Anterior cruciate ligament （ACL） is one of the most vulnerable structures during sports and an essential anterior stabilizing structure in the knee joint. ACL injury can impair a patient’s ability to move, and if not properly treated in time, it often results in serious adverse complications like meniscal and articular cartilage damage, and even traumatic osteoarthritis. Currently, ACL reconstruction is the standard treatment for ACL injury, and the choice of grafts has a significant impact on patients’ postoperative functional recovery and surgical success. Autografts are the most commonly used grafts and have the most stable efficacy, but they have drawbacks like limited sources and donor-site morbidity. Although having greater adaptability, allografts carry a risk of immune rejection and the spread of diseases. Artificial ligaments are appropriate for those who must quickly resume their athletic activities, but they are technically challenging and have not been shown to be long-term effective. Due to the numerous issues with traditional grafts, recent rapid advancements in tissue engineering techniques are generating novel ideas for ACL reconstruction. In order to aid in the treatment of ACL injury, this article discussed the benefits, drawbacks, and clinical effectiveness of different grafts used in ACL reconstruction.

Key words: Knee joint, Anterior cruciate ligament, Graft, Hamstring tendon, Tissue engineering, Reconstruction

中图分类号:

R686

冯建豪, 王家骐. 前交叉韧带重建移植物选择的研究进展[J]. 外科研究与新技术, 2023, 12(2): 125-130.

FENG Jianhao, WANG Jiaqi. Research progress on graft selection in anterior cruciate ligament reconstruction[J]. Surgical Research and New Technique, 2023, 12(2): 125-130.

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