Vanderbilt University Medical Center, Nashville, TN 37232-8774, USA.
Knee Surg Sports Traumatol Arthrosc. 2010 Jan;18(1):98-105. doi: 10.1007/s00167-009-0919-5.
Data from large prospectively collected anterior cruciate ligament (ACL) cohorts are being utilized to address clinical questions regarding ACL injury demographics and outcomes of ACL reconstruction. These data are affected by patient and injury factors as well as surgical factors associated with the site of data collection. The aim of this article is to compare primary ACL reconstruction data from patient cohorts in the United States and Norway, demonstrating the similarities and differences between two large cohorts. Primary ACL reconstruction data from the Multicenter Orthopaedic Outcomes Network (MOON) in the United States and the Norwegian National Knee Ligament Registry (NKLR) were compared to identify similarities and differences in patient demographics, activity at injury, preoperative Knee injury and Osteoarthritis Outcome Score (KOOS), time to reconstruction, intraarticular pathology, and graft choice. Seven hundred and thirteen patients from the MOON cohort were compared with 4,928 patients from the NKLR. A higher percentage of males (NKLR 57%, MOON 52%; P < 0.01) and increased patient age (NKLR 27 years, MOON 23 years; P\0.001) were noted in the NKLR population. The most common sports associated with injury in the MOON cohort were basketball (20%), soccer (17%), and American football (14%); while soccer (42%), handball (26%), and downhill skiing (10%) were most common in the NKLR. Median time to reconstruction was 2.4 (Interquartile range [IQR] 1.2-7.2) months in the MOON cohort and 7.9 (IQR 4.2-17.8) months in the NKLR cohort (P < 0.001). Both meniscal tears (MOON 65%, NKLR 48%; P < 0.001) and articular cartilage defects (MOON 46%, NKLR 26%; P < 0.001) were more common in the MOON cohort. Hamstring autografts (MOON 44%, NKLR 63%) and patellar tendon autografts (MOON 42%, NKLR 37%) were commonly utilized in both cohorts. Allografts were much more frequently utilized in the MOON cohort (MOON 13%, NKLR 0.04%; P < 0.001). Significant diversity in patient, injury, and surgical factors exist among large prospective cohorts collected in different locations. Surgeons should investigate and consider the characteristics of these cohorts when applying knowledge gleaned from these groups to their own patient populations.
来自大型前瞻性前交叉韧带（ACL）队列的数据被用于解决与 ACL 损伤人口统计学和 ACL 重建结果相关的临床问题。这些数据受到患者和损伤因素以及与数据收集地点相关的手术因素的影响。本文的目的是比较美国和挪威的 ACL 初次重建患者队列的数据，展示两个大型队列之间的相似性和差异。比较了美国多中心骨科结果网络（MOON）和挪威国家膝关节韧带登记处（NKLR）的 ACL 初次重建数据，以确定患者人口统计学、损伤时活动、术前膝关节损伤和骨关节炎结果评分（KOOS）、重建时间、关节内病理和移植物选择方面的相似性和差异。将 MOON 队列的 713 例患者与 NKLR 的 4928 例患者进行比较。NKLR 人群中男性比例较高（NKLR 为 57%，MOON 为 52%；P＜0.01），患者年龄也较大（NKLR 为 27 岁，MOON 为 23 岁；P＜0.001）。在 MOON 队列中，与损伤最相关的运动是篮球（20%）、足球（17%）和美式足球（14%）；而在 NKLR 中，最常见的运动是足球（42%）、手球（26%）和下坡滑雪（10%）。MOON 队列的重建中位时间为 2.4（四分位距[IQR] 1.2-7.2）个月，NKLR 队列为 7.9（IQR 4.2-17.8）个月（P＜0.001）。MOON 队列中半月板撕裂（MOON 为 65%，NKLR 为 48%；P＜0.001）和关节软骨损伤（MOON 为 46%，NKLR 为 26%；P＜0.001）更为常见。MOON 队列和 NKLR 队列均常使用腘绳肌腱自体移植物（MOON 为 44%，NKLR 为 63%）和髌腱自体移植物（MOON 为 42%，NKLR 为 37%）。同种异体移植物在 MOON 队列中更为常用（MOON 为 13%，NKLR 为 0.04%；P＜0.001）。在不同地点收集的大型前瞻性队列中，患者、损伤和手术因素存在显著差异。当将从这些组中获得的知识应用于自己的患者人群时，外科医生应调查并考虑这些队列的特征。
