Department of Orthopedic Surgery, and Institute of Clinical Medicine, Akershus University Hospital, University of Oslo, 1478, Lørenskog, Norway.
Knee Surg Sports Traumatol Arthrosc. 2012 Aug;20(8):1533-9. doi: 10.1007/s00167-011-1739-y. Epub 2011 Nov 8.
To investigate differences in patient-reported outcome after anterior cruciate ligament (ACL) reconstruction between patients with and without a concomitant full-thickness cartilage lesion.
30 primary ACL-reconstructed patients with an isolated concomitant full-thickness cartilage lesion and 59 matched controls without cartilage lesions were identified in the Norwegian National Knee Ligament Registry and included in the present study. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used as the outcome measure. At a median follow-up of 2.1 years (range, 2-5 years) after ACL reconstruction, 80 (90%) of the patients completed the KOOS.
Preoperatively, there were no differences in KOOS between the study group and the control group. At follow-up, patients with full-thickness cartilage lesions reported significantly decreased scores compared to patients without cartilage lesions in the KOOS subscales pain (mean difference, 8.1; 95% confidence interval [CI], 0.8-15.3), activities in daily living (mean difference, 5.8; 95% CI, 0.3-11.2), sport/recreation (mean difference, 19.8; 95% CI, 5.3-34.3) and quality of life (mean difference, 17.2; 95% CI, 4.2-30.1). Patients with full-thickness cartilage lesions reported significantly less improvement from preoperative to follow-up than patients without cartilage lesions for the KOOS subscales pain (mean difference, 11.6; 95% CI, 3.2-19.9), sport/recreation (mean difference, 20.6; 95% CI, 8.1-33.1) and quality of life (mean difference, 16.3; 95% CI, 3.8-28.7).
ACL-injured patients with full-thickness cartilage lesions reported worse outcomes and less improvement after ACL reconstruction than those without cartilage lesions at 2-5 years follow-up.
Prognostic; prospective cohort study, Level I.
研究前交叉韧带（ACL）重建后伴有和不伴有全层软骨损伤的患者的患者报告结局（PRO）差异。
在挪威国家膝关节韧带登记处（Norwegian National Knee Ligament Registry）中，确定了 30 例初次 ACL 重建患者（伴有单独的全层软骨损伤）和 59 例匹配的无软骨损伤对照者，并将其纳入本研究。采用膝关节损伤和骨关节炎评分（Knee Injury and Osteoarthritis Outcome Score，KOOS）作为结局测量指标。在 ACL 重建后中位数为 2.1 年（范围 2-5 年）的随访中，80 例（90%）患者完成了 KOOS 评估。
术前，研究组和对照组之间的 KOOS 评分无差异。在随访时，与无软骨损伤的患者相比，全层软骨损伤的患者在 KOOS 亚量表中报告的疼痛（平均差值，8.1；95%置信区间[CI]，0.8-15.3）、日常生活活动（平均差值，5.8；95%CI，0.3-11.2）、运动/娱乐（平均差值，19.8；95%CI，5.3-34.3）和生活质量（平均差值，17.2；95%CI，4.2-30.1）方面的评分显著降低。与无软骨损伤的患者相比，全层软骨损伤的患者从术前到随访的 KOOS 亚量表中疼痛（平均差值，11.6；95%CI，3.2-19.9）、运动/娱乐（平均差值，20.6；95%CI，8.1-33.1）和生活质量（平均差值，16.3；95%CI，3.8-28.7）的改善程度显著降低。
ACL 损伤伴全层软骨损伤的患者在 2-5 年随访时报告的结局更差，且 ACL 重建后的改善程度也较无软骨损伤的患者差。
预后；前瞻性队列研究，Ⅰ级。
