LARS韧带在前交叉韧带重建中的临床应用与关注热点

Clinical application and focus of LARS ligament in anterior cruciate ligament reconstruction

背景:虽然目前重建前交叉韧带的移植物选择包括自体移植物、同种异体移植物和人工合成移植物 3 种主要 类型,但移植物的选择仍是当今的热门研究以及争议点的所在。 目的:综述 LARS 韧带在关节镜下前交叉韧带重建中的早期、中期以及长期临床疗效的国内外研究现状。 方法:应用计算机检索 CNKI 数据库、PubMed 数据库的 2019 年 4 月前发表的相关文献,检索词为“LARS 韧带,前交叉韧带,人工韧带,前交叉韧带重建, LARS ligament, anterior cruciate ligament, artificial ligament, anterior cruciate ligament reconstruction”。通过阅读文章标题和摘要进行初步筛选,排除与文章主题不相关 的文献,根据纳入和排除标准最终纳入 46 篇文献进行综述。 结果与结论:①LARS 韧带拥有出色的生物相容性和力学特性,它的独特结构使成纤维细胞包裹、穿透似生 长,且韧带周围没有炎性反应,巨噬细胞少,由于长入的组织增加了韧带的黏弹性且减少了纤维间的摩擦, 可有效防止碎屑引起的生物反应;LARS 人工韧带弹性模量好,抗扭转、抗疲劳性强;②LARS 韧带重建前交 叉韧带具有快速康复、低失败率和低并发症等优点,表明 LARS 韧带适用于前交叉韧带重建。

BACKGROUND: Although there are three main types of graft selection for anterior cruciate ligament reconstruction:autograft, allogeneic graft and synthetic graft, graft selection is still the focus of current research and controversy.OBJECTIVE: To review the early, mid-term and long-term clinical effects of LARS ligament in the reconstruction of arthroscopic anteriorcruciate ligament.METHODS: The related literatures published before April 2019 in CNKI database and PubMed database were searched by computer with thesearch terms “LARS ligament, anterior cruciate ligament, artificial ligament, anterior cruciate ligament reconstruction” in Chinese and Englishrespectively. After preliminary screening by reading titles and abstracts, irreverent literatures were excluded. Forty-six eligible literatures wereincluded.RESULTS AND CONCLUSION: LARS ligament had excellent biocompatibility and mechanical properties. Its unique structure allowed fibroblaststo grow in the forms of wrapping and penetration, and there was no inflammatory reaction around the ligament and fewer macrophages wereobserved. Because the growing tissue increased the viscoelasticity of the ligament and reduced the friction between the fibers, so it can effectivelyprevent the biological reaction caused by detritus. LARS ligament had good elastic modulus, anti-torsion and fatigue resistance properties. LARSligament was suitable for anterior cruciate ligament reconstruction because of its rapid recovery, low failure rate, and few complications.