Knee surgery & related research · 2026 · 統合分析（依標題推測）

Clinical outcomes of quadriceps, hamstring, and bone-patellar tendon-bone autografts for ACL reconstruction: a meta-analysis of randomized controlled trials.

膝 · 前十字韌帶損傷

中文閱讀摘要

統合分析顯示，ACL重建中股四頭肌、腘繩肌與股骨髁-髌腱-股骨髁自體移植物在功能、穩定度及併發症上無顯著差異，但直接比較試驗有限。

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原始摘要

Background

The quadriceps tendon (QT) has emerged as a reliable autograft for anterior cruciate ligament reconstruction (ACLR), but uncertainty remains regarding several key comparative aspects-particularly donor-site morbidity, long-term graft survival, knee stability, and complication rates-when evaluated against hamstring tendon (HT) and bone-patellar tendon-bone (BPTB) autografts. High-level evidence restricted to randomized controlled trials directly comparing QT with HT or BPTB remains limited. To compare clinical outcomes, graft failure, donor-site morbidity, and knee stability among QT, HT, and BPTB autografts for primary ACLR using level-I and level-II randomized controlled trials (RCTs).

Methods

The MEDLINE (PubMed), Embase (Elsevier), and Cochrane Library databases were searched on 1 September 2025, and repeated 2 weeks later. Only level-I or -II RCTs comparing QT to HT or BPTB in primary ACLR were included. Random-effects meta-analyses were performed for International Knee Documentation Committee (IKDC) and Lysholm scores, instrumented laxity, graft failure, donor-site morbidity, and reoperation. Risk of bias was assessed with RoB 2.0, and small-study effects with funnel and doi plots.

Results

Eleven RCTs (mean follow-up, 2-10 years) were included. Pooled IKDC scores averaged 84.8 (95% CI 81.9-87.9) and Lysholm scores averaged 93.1 (95% CI 91.6-94.6), with no significant differences between QT and either comparator (P > 0.05). Side-to-side anterior tibial translation averaged 1.2 mm (95% CI 0.99-1.54 mm) across all grafts, also without significant differences (P > 0.05). Pooled graft failure and ipsilateral reoperation rates were 0.7% (95% CI 0.0-1.9%) and 2.3% (95% CI 0.6-4.7%), respectively, again with no between-graft differences (P > 0.05). Donor-site morbidity did not differ significantly between QT and HT (mean 13.83 [95% CI 9.6-19.83]; P > 0.05).

Conclusion

This meta-analysis of level-I/II randomized controlled trials found no statistically significant differences among quadriceps tendon, hamstring tendon, and bone-patellar tendon-bone autografts in patient-reported outcomes, knee stability, graft re-rupture, or additional knee surgery. Donor-site morbidity comparisons were limited by incomplete reporting, particularly for BPTB. These findings suggest that contemporary surgical techniques and rehabilitation protocols may minimize graft-specific differences in mid-term outcomes, although interpretation should consider the limited number of direct comparative trials across all three graft types. Level of evidence Systematic review and meta-analysis; level of evidence, 1 and 2.

至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19

書目、來源與全文狀態

DOI: 10.1186/s43019-026-00320-w
PMID／PMCID: 42098886 / PMC13154517
作者: D'Ambrosi R, Farinelli L, Franco P, Marchetti A, Meena A, Milinkovic DD, Kambhampati SB, Sconfienza LM, Patt T, Ursino C, Abermann E, Fink C
首次發表日期: 2026-05-07Europe PMC 提供，部分日期可能依年份或月份推定。
卷／期／頁碼或文章編號: 38 ／ 1 ／ 19
書目來源與查核日期: Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
全文與授權: 來源列有免費全文（查核 2026-10-19），未逐篇測試 PDF 下載。來源授權標示：cc by。

可回溯引用

D'Ambrosi R, Farinelli L, Franco P, Marchetti A, Meena A, Milinkovic DD, Kambhampati SB, Sconfienza LM, Patt T, Ursino C, Abermann E, Fink C. Clinical outcomes of quadriceps, hamstring, and bone-patellar tendon-bone autografts for ACL reconstruction: a meta-analysis of randomized controlled trials. Knee surgery & related research. 2026;38(1):19. PMID: 42098886. PMCID: PMC13154517. doi:10.1186/s43019-026-00320-w

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