Möller Eva, Weidenhielm Lars, Werner Suzanne
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm Sports Trauma Research Center, Sophiahemmet, Box 5605, 114 86, Stockholm, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2009 Jul;17(7):786-94. doi: 10.1007/s00167-009-0788-y. Epub 2009 Apr 10.
The aim of the present investigation was to study patient-reported long-term outcome after anterior cruciate ligament (ACL) reconstruction. On an average 11.5 years after ACL reconstruction with bone-patellar tendon-bone (BPTB) autograft 56 patients were asked to answer four different questionnaires about their knee function and knee-related quality of life. Another aim was to study whether there were any correlations between clinical tests, commonly used for evaluating patients with ACL injuries, which were performed 2 years after ACL reconstruction, and patient-reported outcome in terms of knee function and knee-related quality of life on an average 9.5 years later. All patients who had unilateral BPTB ACL reconstructions were examined at 2 years and on an average 11.5 years after surgery. At 2 years one-leg hop test for distance, isokinetic muscle torque measurement, sagittal knee laxity, Lysholm knee scoring scale and Tegner activity scale were used for clinical evaluation. At the follow-up on an average 9.5 years later the patients were evaluated with knee injury osteoarthritis outcome score (KOOS), short form health survey (SF 36), Lysholm knee scoring scale and Tegner activity scale. The SF-36 showed that the patients had a similar health condition as an age- and gender-matched normal population in Sweden on an average 11.5 years after ACL reconstruction. There was no correlation between the results of one-leg hop test for distance, isokinetic muscle torque measurement, sagittal knee laxity evaluated 2 years after surgery and the result of KOOS (function in sport and recreation, knee-related quality of life) and SF-36 evaluated on an average 11.5 years after surgery. We also compared patients that 2 years after surgery demonstrated a side-to-side difference in anterior-posterior knee laxity of more than 3 mm with those with 3 mm or less and found no significant group differences in terms of knee function as determined with KOOS. We found no correlation between the results of KOOS and SF-36 at the long-term follow-up and the time between injury and surgery, age at surgery or gender, respectively. We conclude that there is no correlation between patient-reported knee function in sport and recreation and knee-related quality of life on an average 11.5 years after BPTP ACL reconstruction and the evaluation methods used 2 years after surgery.
本研究的目的是探讨前交叉韧带（ACL）重建术后患者报告的长期预后。在采用骨-髌腱-骨（BPTB）自体移植物进行ACL重建平均11.5年后，56例患者被要求回答四份关于其膝关节功能和膝关节相关生活质量的不同问卷。另一个目的是研究在ACL重建术后2年进行的、常用于评估ACL损伤患者的临床检查，与平均9.5年后患者报告的膝关节功能和膝关节相关生活质量的预后之间是否存在任何相关性。所有接受单侧BPTB ACL重建的患者在术后2年和平均11.5年时接受检查。在术后2年，采用单腿跳远距离测试、等速肌肉扭矩测量、膝关节矢状面松弛度、Lysholm膝关节评分量表和Tegner活动量表进行临床评估。在平均9.5年后的随访中，采用膝关节损伤和骨关节炎转归评分（KOOS）、简短健康调查问卷（SF-36）、Lysholm膝关节评分量表和Tegner活动量表对患者进行评估。SF-36显示，在ACL重建平均11.5年后，患者的健康状况与瑞典年龄和性别匹配的正常人群相似。术后2年进行的单腿跳远距离测试、等速肌肉扭矩测量、膝关节矢状面松弛度结果，与术后平均11.5年评估的KOOS（运动和娱乐功能、膝关节相关生活质量）和SF-36结果之间无相关性。我们还比较了术后2年膝关节前后松弛度侧方差异超过3 mm的患者与差异为3 mm或更小的患者，发现就KOOS所确定的膝关节功能而言，两组之间无显著差异。我们发现在长期随访中，KOOS和SF-36的结果分别与受伤至手术的时间、手术年龄或性别之间无相关性。我们得出结论，在BPTP ACL重建平均11.5年后，患者报告的运动和娱乐方面的膝关节功能及膝关节相关生活质量，与术后2年使用的评估方法之间无相关性。
