腓骨长肌腱自体移植物与腘绳肌腱自体移植物在原发性前交叉韧带重建术中的应用：随机对照试验的系统评价与Meta分析
简介
该系统综述和荟萃分析纳入4项随机对照试验共407例患者，比较初次ACL重建中腓骨长肌腱与腘绳肌腱自体移植物的疗效。结果显示两组Lysholm、IKDC评分及膝关节稳定性相当，但腓骨长肌腱组改良Cincinnati评分更优、移植物直径更大，且供区并发症发生率显著更低。提示腓骨长肌腱可作为ACL重建中可靠的替代移植物选择，尤其适用于关注供区并发症的患者。
英文摘要
BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) is a commonly performed procedure aimed at restoring knee stability and function following ligament injury. Although hamstring tendon (HT) autografts are widely used, concerns regarding donor-site morbidity and graft-related limitations persist. The peroneus longus tendon (PLT) has recently gained attention as an alternative autograft, offering favourable biomechanical properties and potentially reduced morbidity. However, evidence comparing clinical outcomes between PLT and HT autografts remains limited and inconsistent. Therefore, this study aimed to systematically evaluate and compare the efficacy and safety of PLT versus HT autografts in primary ACLR using high-level evidence from randomised controlled trials (RCTs). METHODS: A systematic review and meta-analysis of RCTs comparing PLT and HT autografts in primary ACLR was conducted. Databases were searched up to December 2025. Outcomes included patient-reported scores, knee stability, graft characteristics, donor-site morbidity, and ankle function. RESULTS: Four RCTs involving 407 patients were included. Lysholm and IKDC scores were comparable between groups. The PLT group demonstrated significantly better modified Cincinnati scores (MD, 3.02; P = 0.0004) and larger graft diameter. Donor-site morbidity was significantly lower with PLT (OR 0.12; P = 0.007). Knee stability and graft failure rates were similar. AOFAS scores showed no significant postoperative decline. CONCLUSION: PLT autografts provide outcomes comparable to HT with potential advantages in donor-site morbidity and graft characteristics, supporting their use as a reliable alternative in ACLR.