前交叉韧带重建术（ACLR）的外侧关节外腱鞘增量术最常用于枢轴移位≥2级和前交叉韧带重建术的翻修。

IF 4.4 1区医学 Q1 ORTHOPEDICS

Arthroscopy-The Journal of Arthroscopic and Related Surgery Pub Date : 2024-10-01 DOI:10.1016/j.arthro.2024.01.031

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引用次数: 0

摘要

目的：本研究旨在确定 LET 增强 ACLR 的最常见适应症：采用系统综述和元分析首选报告项目 (PRISMA) 指南对文献进行了系统综述。我们检索了 2000 年至今的 PubMed、EMBASE、Web of Science 和 Cochrane。符合以下标准的研究均被纳入：除 ACLR 外还接受了 LET 的任何年龄段的患者、报告了至少一种 LET 适应症的研究、观察性/研究设计（包括适应症的流行程度）。文章必须以英语撰写，经过同行评审，且源自美国或提供相同方案和程序的国家：初步搜索共发现 463 项研究，其中 23 项符合纳入标准并被纳入审查范围。这 23 项研究中有 8 项（34.8%）使用了改良的 Lemaire 技术，7 项（30.4%）使用了经 Arnold-Coker 改良的 MacIntosh 技术，8 项（34.8%）使用了其他技术进行 LET。共有2125名患者（53%为女性，47%为男性，3项研究未报告性别）接受了前交叉韧带置换术，并使用了LET。适应症及发生率如下：枢轴移位试验阳性（≥2级）（19/23，82.6%）、翻修前交叉韧带置换术（12/23，52.2%）、韧带松弛（11/23，47.8%）、一般运动参与（11/23，47.8%）、年龄小于25岁（8/23，34.8%）、移植物失败风险高（5/23，21.7%）、Lachman试验阳性（4/23，17.4%）：枢轴移位≥2级是矫形外科医生选择在前交叉韧带置换术中添加LET的最常见原因，前交叉韧带置换术翻修、患者年龄、证据等级：I-IV级研究的系统回顾。

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Lateral Extra-articular Tenodesis Augmentation of Anterior Cruciate Ligament Reconstruction Is Most Commonly Indicated for Pivot Shift of Grade 2 or Greater and for Revision Anterior Cruciate Ligament Reconstruction

Purpose

To determine the most common indications for lateral extra-articular tenodesis (LET) augmentation of anterior cruciate ligament reconstruction (ACLR).

Methods

A systematic review of the literature was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, Embase, Web of Science, and Cochrane Database of Systematic Reviews from 2000 to the present (June 2022). Studies that met the following criteria were included: patients of any age who underwent LET in addition to ACLR, studies reporting at least 1 indication for LET, and observational/randomized controlled trial study designs including prevalence of indications. Publications had to be reported in English and peer reviewed and to have originated in the United States or countries offering identical protocols and procedures.

Results

A total of 463 studies were identified from the initial search, 23 of which met inclusion criteria and were included in the review. Eight of the 23 studies (34.8%) used a modified Lemaire technique, seven (30.4%) used a MacIntosh modified by Arnold-Coker, and eight (34.8%) used other techniques to perform LET. A total of 2,125 patients (53% female, 47% male [3 studies did not report sex]) underwent ACLR augmented with LET. The indications along with prevalence were as follows: positive pivot shift test (grade ≥2) (19 of 23, 82.6%), revision ACLR (12 of 23, 52.2%), ligamentous laxity (11 of 23, 47.8%), general sports participation (11 of 23, 47.8%), age less than 25 years (8 of 23, 34.8%), high risk of graft failure (5 of 23, 21.7%), and positive Lachman test (4 of 23, 17.4%).

Conclusions

Pivot shift grade ≥2 was the most common reason orthopaedic surgeons chose to add LET to ACLR, with revision ACLR, patient age <25, and general sports participation following closely behind.

Level of Evidence

Level IV, systematic review of Level I-IV studies.

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来源期刊

Arthroscopy-The Journal of Arthroscopic and Related Surgery 医学-外科

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.