Karlsson J, Kartus J, Magnusson L, Larsson J, Brandsson S, Eriksson B I
Department of Orthopaedics, Sahlgrenska University Hospital/Ostra, Göteborg, Sweden.
Knee Surg Sports Traumatol Arthrosc. 1999;7(3):146-51. doi: 10.1007/s001670050139.
The objective of this study was to compare the function and activity level in patients with anterior cruciate ligament injuries, who participated in competitive sports (Tegner activity level > or = 7) and underwent a reconstruction of the anterior cruciate ligament, either subacute (2-12 weeks, group I) or late (12-24 months, group II) after the injury. The patients in group I (n = 97) were comparable with those in group II (n = 103) in terms of gender, age, preinjury activity level, and the reconstruction technique. At the final follow-up (2-5.5 years after the operation), the Lysholm score, the IKDC evaluation system and the one-leg-hop test revealed no differences between the groups. There were also no differences between the groups in terms of the patients' subjective evaluation or expectations. The Tegner activity level at follow-up was 8 (range 2-10) in group I and 6 (range 2-9) in group II (P = 0.0001). The same thing was found in terms of the desired Tegner activity level, which was 9 (range 4-9) in group I and 7 (range 3-10) in group II (P = 0.0002). The KT-1000 laxity meter revealed a total side-to-side difference of 1.5 mm (-3.5-8.5) in group I and 1.5 mm (-3.5-7) in group II (NS). Associated meniscal surgery between the index injury and the reconstruction, or during the reconstruction, was performed in 37/97 (38%) of the patients in group I and 59/103 (57%) of the patients in group II (P < 0.01). This study revealed that competitive athletes who underwent reconstruction at a subacute stage after the anterior cruciate ligament injury had a higher activity level 2-5.5 years after the index operation, as well as a higher desired level of activity compared to athletes who had the reconstruction delayed by 12-24 months. Furthermore, meniscal injuries were significantly more frequent if the reconstruction was delayed.
本研究的目的是比较前交叉韧带损伤且参加竞技运动（Tegner活动水平≥7）并接受前交叉韧带重建的患者的功能和活动水平，这些患者在损伤后亚急性期（2 - 12周，I组）或晚期（12 - 24个月，II组）接受重建。I组（n = 97）患者与II组（n = 103）患者在性别、年龄、伤前活动水平和重建技术方面具有可比性。在最终随访时（术后2 - 5.5年），Lysholm评分、IKDC评估系统和单腿跳测试显示两组之间无差异。两组患者的主观评估或期望也无差异。随访时I组的Tegner活动水平为8（范围2 - 10），II组为6（范围2 - 9）（P = 0.0001）。在期望的Tegner活动水平方面也发现了同样的情况，I组为9（范围4 - 9），II组为7（范围3 - 10）（P = 0.0002）。KT - 1000松弛度计显示I组的总侧方差异为1.5 mm（-3.5 - 8.5），II组为1.5 mm（-3.5 - 7）（无显著性差异）。I组中37/97（38%）的患者以及II组中59/103（57%）的患者在初次损伤与重建之间或重建期间进行了相关半月板手术（P < 0.01）。本研究表明，前交叉韧带损伤后在亚急性期接受重建的竞技运动员在初次手术后2 - 5.5年的活动水平更高，与重建延迟12 - 24个月的运动员相比，其期望的活动水平也更高。此外，如果重建延迟，半月板损伤明显更频繁。
