Wright Rick W, Dunn Warren R, Amendola Annunziato, Andrish Jack T, Bergfeld John, Kaeding Christopher C, Marx Robert G, McCarty Eric C, Parker Richard D, Wolcott Michelle, Wolf Brian R, Spindler Kurt P
Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, Missouri 63110, USA.
Am J Sports Med. 2007 Jul;35(7):1131-4. doi: 10.1177/0363546507301318. Epub 2007 Apr 23.
The risk of tear of the intact anterior cruciate ligament in the contralateral knee after anterior cruciate ligament reconstruction of the opposite knee and the incidence of rupturing the anterior cruciate ligament graft during the first 2 years after surgery have not been extensively studied in a prospective manner. Clinicians have hypothesized that the opposite normal knee is at equal or increased risk compared with the risk of anterior cruciate ligament graft rupture in the operated knee.
The risk of anterior cruciate ligament graft rupture and contralateral normal knee anterior cruciate ligament rupture at 2-year follow-up is equal.
Cohort study; Level of evidence, 2.
The Multicenter Orthopaedic Outcome Network (MOON) database of a prospective longitudinal cohort of anterior cruciate ligament reconstructions was used to determine the number of anterior cruciate ligament graft ruptures and tears of the intact anterior cruciate ligament in the contralateral knee at 2-year follow-up. Two-year follow-up consisted of a phone interview and review of operative reports.
Two-year data were obtained for 235 of 273 patients (86%). There were 14 ligament disruptions. Of these, 7 were tears of the intact anterior cruciate ligament in the contralateral knee (3.0%) and 7 were anterior cruciate ligament graft failures (3.0%).
The contralateral normal knee anterior cruciate ligament is at a similar risk of anterior cruciate ligament tear (3.0%) as the anterior cruciate ligament graft after primary anterior cruciate ligament reconstruction (3.0%).
对侧膝关节前交叉韧带重建术后,对侧完整前交叉韧带撕裂的风险以及术后头两年内前交叉韧带移植物破裂的发生率尚未得到广泛的前瞻性研究。临床医生推测,与手术侧膝关节前交叉韧带移植物破裂的风险相比,对侧正常膝关节的风险相同或更高。
在2年随访时,前交叉韧带移植物破裂和对侧正常膝关节前交叉韧带破裂的风险相等。
队列研究;证据等级,2级。
采用多中心骨科结果网络(MOON)数据库中一个前交叉韧带重建前瞻性纵向队列的数据,以确定2年随访时前交叉韧带移植物破裂的数量以及对侧膝关节完整前交叉韧带的撕裂情况。2年随访包括电话访谈和手术报告回顾。
273例患者中的235例(86%)获得了2年的数据。共有14例韧带断裂。其中,7例为对侧膝关节完整前交叉韧带撕裂(3.0%),7例为前交叉韧带移植物失效(3.0%)。
在初次前交叉韧带重建后,对侧正常膝关节前交叉韧带发生前交叉韧带撕裂的风险(3.0%)与前交叉韧带移植物的风险相似(3.0%)。