Allografts and Autografts in Primary Hip Labral Reconstruction Result in Improved Postoperative Outcomes, With Autografts Demonstrating Lower Revision and Complication Rates: A Systematic Review.

IF 5.4 1区 医学 Q1 ORTHOPEDICS
Colton C Mowers, Justin T Childers, Benjamin T Lack, Ariel S Hus, Matthew T McKinley, Garrett R Jackson, Steven F DeFroda
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引用次数: 0

Abstract

Purpose: To compare patient-reported outcomes, complications and revision rates following the use of autograft versus allograft for primary arthroscopic hip labral reconstruction.

Methods: The PubMed, Scopus, and Embase databases were queried following the 2020 PRISMA guidelines to identify human clinical studies reporting outcomes following primary arthroscopic hip labral reconstruction with a minimum follow-up of two years. Studies that did not report graft type or outcomes were excluded. Studies were separated into two cohorts based on graft type, allograft or autograft. The mean delta (change from preoperative to postoperative values) was calculated for each patient reported outcome score and compared between cohorts. The MINORS criteria was used to evaluate bias.

Results: Seventeen studies (allograft=9 studies, autograft=11 studies) of 756 patients were included. Mean follow-up for the allograft cohort was 37 months (mean range, 25.5-66.1) compared to 38.3 months (mean range, 25.4-80.8) for the autograft cohort. At final follow-up, delta values for modified Harris Hip Score ranged from 18.2-34 (allograft) versus 9.4-31.7 (autograft), HOS-Sports scale ranged from 24.2-39.7 (allograft) versus 21.4-41.3 (autograft), Visual Analog Pain scale ranged from -5.7 to -1.7 (allograft) versus -5.7 to -2.4 (autograft), and delta values for the Non-Arthritic Hip score ranged from 19.7-31.3 (allograft) versus 16.6-35.4 (autograft). Postoperative complication rates ranged from 0.0% to 17.6% (allograft) versus 0.0% to 9.1% (autograft). The most common complication for the allograft cohort was numbness (n=2) versus heterotopic ossification (n=6) in the autograft cohort. Rates of arthroscopic revision surgery were 0.0% to 5.9% (allograft) versus 0.0% to 9.1% (autograft), while conversion to total hip arthroplasty ranged from 0.0% to 17.6% (allograft) versus 0.0% to 8.3% (autograft).

Conclusion: The use of allografts and autografts in primary hip labral reconstruction results in improved postoperative outcomes. However, allografts were associated with higher rates of complications with worse graft survivorship.

Level of evidence: IV, Systematic Review of Level of Evidence III-IV Studies.

异体移植和自体移植在初次髋关节唇部重建中的效果更好,自体移植具有更低的翻修率和并发症发生率:一项系统综述。
目的:比较自体移植物与同种异体移植物用于一期关节镜下髋关节唇部重建后患者报告的结果、并发症和翻修率。方法:根据2020年PRISMA指南查询PubMed, Scopus和Embase数据库,以确定至少随访两年的初级关节镜髋关节唇部重建后的人类临床研究报告结果。未报道移植物类型或结果的研究被排除。研究根据移植物类型、同种异体移植物或自体移植物分为两组。计算每个患者报告的结果评分的平均增量(术前到术后值的变化),并在队列之间进行比较。采用minor标准评价偏倚。结果:纳入17项研究(同种异体移植=9项研究,自体移植=11项研究)756例患者。同种异体移植队列的平均随访时间为37个月(平均范围为25.5-66.1),而自体移植队列的平均随访时间为38.3个月(平均范围为25.4-80.8)。在最后的随访中,改良Harris髋关节评分的delta值从18.2-34(同种异体移植)到9.4-31.7(自体移植),HOS-Sports评分从24.2-39.7(同种异体移植)到21.4-41.3(自体移植),视觉模拟疼痛评分从-5.7到-1.7(同种异体移植)到-5.7到-2.4(自体移植),非关节炎髋关节评分的delta值从19.7到31.3(同种异体移植)到16.6到35.4(自体移植)。术后并发症发生率为0.0% - 17.6%(同种异体移植)和0.0% - 9.1%(自体移植)。同种异体移植队列中最常见的并发症是麻木(n=2)和自体移植队列中异位骨化(n=6)。关节镜下翻修手术的比例为0.0% - 5.9%(同种异体移植)和0.0% - 9.1%(自体移植),而全髋关节置换术的比例为0.0% - 17.6%(同种异体移植)和0.0% - 8.3%(自体移植)。结论:自体和异体移植在初次髋关节唇部重建术中的应用改善了术后的预后。然而,同种异体移植物的并发症发生率较高,移植物存活率较差。证据水平:IV,证据水平III-IV研究的系统评价。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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