前交叉韧带（ACL）重建中混合异体移植物增强与单纯自体移植物的患者预后比较：系统综述与Meta分析
简介
该系统综述与Meta分析纳入17项研究（15项回顾性队列），比较混合同种异体移植物增强与单纯自体移植物行ACL重建。汇总显示，自体组Lysholm评分虽略高但未达最小临床重要差异，IKDC、Tegner评分及移植物失败率两组无显著差异。提示混合同种异体移植物增强未显示明确临床获益。
英文摘要
Anterior cruciate ligament reconstruction (ACLR) is a common orthopedic procedure involving the replacement of a torn anterior cruciate ligament (ACL) with a graft, and current literature comparing the outcomes of different graft types remains inconclusive. The aim of this study was to compare isolated autografts and hybrid allograft/autograft grafts of various sizes to determine whether allograft augmentation provides a clinically significant benefit during ACLR by assessing patient-reported outcome measures (PROMs) and rates of graft failure. A comprehensive systematic review and meta-analysis was performed, with the search conducted across three databases (PubMed, Embase, and Cochrane Reviews). Quantitative data were collected regarding PROMs and rates of re-tear/revision, and a meta-analysis was performed to assess Lysholm, International Knee Documentation Committee (IKDC), and Tegner scores and rates of graft failure. The initial search yielded 249 studies, of which 17 met the final inclusion criteria; the included studies were published between 2015 and 2025, and 15 of the 17 were retrospective cohort studies. In terms of pooled patient outcomes, there were no clinically significant differences between hybrid grafts and isolated autografts across any of the analyzed clinical scores. Lysholm scores were statistically higher in the autograft group (weighted mean difference (WMD) 3.77, 95% CI 1.47-6.07, p=0.0013), though this difference remained below the established minimal clinically important difference; IKDC (p=0.80) and Tegner (p=0.28) scores did not differ significantly between groups. The pooled relative risk of graft failure was slightly higher in patients with hybrid grafts (risk ratio (RR) 1.24, 95% CI 0.84-1.84); however, this difference was not statistically significant (p=0.28). At the individual study level, there is literature to both support and refute the viability of hybrid ACL grafts in augmenting an autograft of insufficient diameter. However, following a comprehensive review of the literature and meta-analysis, we report a lack of clinically meaningful or statistically significant differences in clinical outcome scores and overall rates of graft failure.