股直肌腱自体移植物与腘绳肌腱自体移植物早期疗效相当，但证据仍有限：一项系统评价
简介
这项系统综述纳入4项比较研究（共324例），评估股直肌腱与腘绳肌腱自体移植物在初次及翻修ACL重建中的早期疗效。结果显示两组临床结果、股四头肌力量及供区并发症总体相当，但一项翻修研究中股直肌组移植物失败率更低（2.3% vs 17.4%）。鉴于证据等级仅为IV级且随访时间短，常规首选移植物不可用时可将股直肌腱作为翻修术的备选，尚不支持其作为初次重建的常规选择…
英文摘要
PURPOSE: To compare clinical outcomes, strength, donor-site morbidity, complications and graft failure after primary or revision anterior cruciate ligament reconstruction (ACLR) using rectus femoris tendon (RT) versus hamstring tendon (HT) autografts. METHODS: A systematic review was conducted in accordance with preferred reporting items for systematic reviews and meta-analyses 2020. Comparative clinical studies of RT and HT autografts in primary or revision ACLR were included. Outcomes were synthesised narratively because of the small number of studies and clinical and methodological heterogeneity. RESULTS: Four comparative studies enrolled 324 patients, of whom 299 were available for final comparative analysis (RT, n = 142; HT, n = 157). Two studies evaluated primary and two evaluated revision ACLR. Three studies reported patient-reported outcomes. One revision study found higher International Knee Documentation Committee scores (83.8 ± 12.2 vs. 78.6 ± 16.8; p = 0.037) and Tegner scores (5.8 ± 1.8 vs. 5.6 ± 1.5; p = 0.043) with RT; however, the absolute differences were small, and attainment of a minimal clinically important difference was not reported. The other two studies found no significant between-group differences. At approximately 6 months, quadriceps peak torque did not differ between RT and HT (173.0 ± 62.0 vs. 167.7 ± 45.7 Nm; p = 0.689). Failure rates were 2.3% versus 17.4% (p = 0.031) in one revision study and 7.1% versus 7.4% in another. Donor-site morbidity was reported quantitatively in one study and did not differ significantly (4.7% vs. 13.0%; p = 0.268). CONCLUSION: RT autografts produced early clinical outcomes broadly comparable to HT autografts, but the evidence base comprises only four heterogeneous comparative studies with short and unequal follow-up. RT may be considered when established autografts are unavailable, particularly in revision ACLR; routine use in primary ACLR cannot yet be recommended. LEVEL OF EVIDENCE: Level IV.