前交叉韧带重建中生物增强后的功能与重返运动结局：系统评价与Meta分析
简介
本系统评价与荟萃分析纳入了10项比较研究，评估前交叉韧带重建术中生物增强（如PRP、干细胞等）对功能恢复和重返运动的影响。关键发现：生物增强组Tegner活动评分（平均差0.52，95%CI 0.14-0.91）和Lysholm评分（平均差3.32，95%CI 0.65-6.00）略高于标准重建组，但IKDC评分无显著差异；仅2项研究报告重返运动结局，且数据…
英文摘要
BACKGROUND: The clinical value of biologic augmentation during anterior cruciate ligament reconstruction remains uncertain, particularly regarding functional recovery and return to sport. Existing evidence has yielded inconsistent results, and prior syntheses have often emphasized radiologic outcomes rather than patient-centered functional measures. METHODS: A systematic review and random-effects meta-analysis of comparative clinical studies evaluating biologic augmentation during anterior cruciate ligament reconstruction was conducted. PubMed, the Cochrane Library, and Google Scholar were searched without date restrictions. Tegner activity score, Lysholm knee score, International Knee Documentation Committee score, and return-to-sport outcomes were analyzed when available. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool and the MINORS criteria. RESULTS: Ten studies were included. Biologic augmentation was associated with higher Tegner activity scores compared with standard reconstruction, with a pooled mean difference of 0.52 (95% confidence interval 0.14 to 0.91) and no observed heterogeneity. Lysholm knee scores were also higher in the biologic augmentation group (mean difference 3.32, 95% confidence interval 0.65 to 6.00), although substantial heterogeneity persisted across studies. No significant difference was observed in pooled International Knee Documentation Committee scores. Return-to-sport outcomes were reported inconsistently in only two studies and were not suitable for quantitative synthesis. Most randomized studies demonstrated some concerns regarding risk of bias, while non-randomized studies showed moderate methodological limitations. CONCLUSION: Biologic augmentation during anterior cruciate ligament reconstruction is associated with modest improvements in selected functional outcomes but does not result in consistent gains in global knee function or return-to-sport outcomes. Current evidence does not support routine use of biologic augmentation in primary anterior cruciate ligament reconstruction.