前交叉韧带重建移植物选择及其对重返运动影响的叙述性综述
简介
这篇叙述性综述总结骨-髌腱-骨（BTB）、腘绳肌腱、股四头肌腱和同种异体移植物选择对ACL重建后重返运动（RTS）的影响。综述汇总的证据显示，术后3年RTS率约为65%–73%，精英和高中运动员为83%–90%；在年轻活跃患者中，自体移植物与更高的RTS率和更低的翻修率相关，但包括随机试验meta分析在内的高级别证据尚未确立任一自体移植物更优。RTS仅是AC…
英文摘要
PURPOSE OF REVIEW: Anterior cruciate ligament (ACL) rupture is among the most common knee injuries in active individuals and can lead to persistent instability, secondary intra-articular damage, and an elevated risk of osteoarthritis. Because return to sport (RTS) is a major goal for most active patients and graft selection remains one of the most debated aspects of ACL reconstruction, this narrative review summarizes the contemporary evidence on how graft choice influences RTS, focusing on the four most common grafts: bone-patellar tendon-bone (BTB), hamstring tendon (HT), quadriceps tendon (QT), and allograft. RECENT FINDINGS: RTS rates range from ~ 65% to 73% at three years and are higher (83-90%) in elite and high-school athletes. In young, active patients, autografts are associated with higher RTS and lower revision rates than allografts, and high-level evidence-including randomized-trial meta-analyses-has not established the superiority of any single autograft. BTB offers reliable bone-to-bone healing and low revision rates; HT reduces donor-site morbidity and anterior knee pain but has variable diameter and possible flexion weakness; and QT is a versatile option with favorable biomechanics, low donor-site morbidity, and encouraging RTS data, including in skeletally immature athletes. RTS is one of several important outcomes after ACL reconstruction, alongside long-term joint health and reinjury prevention. For RTS, the literature supports autograft over allograft in young, active patients while identifying no universally superior autograft. Graft selection should be individualized to patient age, sport, activity level, anatomy, and reinjury risk; the senior author favors QT or BTB autografts for high-demand athletes.