移植物大小和患者年龄是前交叉韧带重建采用自体腘绳肌腱移植物后早期翻修的预测因子。
Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft.
机构信息
Department of Orthopaedic Surgery, The Ohio State University School of Medicine, Columbus, Ohio, USA.
出版信息
Arthroscopy. 2012 Apr;28(4):526-31. doi: 10.1016/j.arthro.2011.11.024. Epub 2012 Feb 1.
PURPOSE
To evaluate whether decreased hamstring autograft size and decreased patient age are predictors of early graft revision.
METHODS
Of 338 consecutive patients undergoing primary anterior cruciate ligament (ACL) reconstruction with hamstring autograft, 256 (75.7%) were evaluated. Graft size and patient age, gender, and body mass index at the time of ACL reconstruction were recorded, along with whether subsequent ACL revision was performed.
RESULTS
The 256 patients comprised 136 male and 120 female patients and ranged in age from 11 to 52 years (mean, 25.0 years). The mean follow-up was 14 months (range, 6 to 47 months). Revision ACL reconstruction was performed in 18 of 256 patients (7.0%) at a mean of 12 months after surgery (range, 3 to 31 months). Revision was performed in 1 of 58 patients (1.7%) with grafts greater than 8 mm in diameter, 9 of 139 patients (6.5%) with 7.5- or 8-mm-diameter grafts, and 8 of 59 patients (13.6%) with grafts 7 mm or less in diameter (P = .027). There was 1 revision performed in the 137 patients aged 20 years or older (0.7%), but 17 revisions were performed in the 119 patients aged under 20 years (14.3%) (P < .0001). Most revisions (16 of 18) were noted to occur in patients aged under 20 years with grafts 8 mm in diameter or less, and the revision rate in this population was 16.4% (16 of 97 patients). Age less than 20 years at reconstruction (odds ratio [OR], 18.97; 95% confidence interval [CI], 2.43 to 147.06; P = .005), decreased graft size (OR, 2.20; 95% CI, 1.00 to 4.85; P = .05), and increased follow-up time (OR, 1.07; 95% CI, 1.02 to 1.12) were associated with increased risk of revision.
CONCLUSIONS
Decreased hamstring autograft size and decreased patient age are predictors of early graft revision. Use of hamstring autografts 8 mm in diameter or less in patients aged under 20 years is associated with higher revision rates.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.
目的
评估腘绳肌腱移植物尺寸减小和患者年龄减小是否是早期移植物翻修的预测因素。
方法
对 338 例连续行前交叉韧带（ACL）重建的患者进行分析，其中 256 例（75.7%）进行了评估。记录了 ACL 重建时的移植物大小和患者年龄、性别以及身体质量指数，同时记录了是否进行了后续 ACL 翻修。
结果
256 例患者中，男性 136 例，女性 120 例，年龄 1152 岁（平均 25.0 岁）。平均随访时间为 14 个月（647 个月）。256 例患者中有 18 例（7.0%）在术后 12 个月（331 个月）行 ACL 翻修重建。在直径大于 8mm 的移植物中，有 1 例（1.7%）患者行翻修；在 7.58mm 直径的移植物中，有 9 例（6.5%）患者行翻修；在直径为 7mm 或更小的移植物中，有 8 例（13.6%）患者行翻修（P=0.027）。在 20 岁或以上的 137 例患者中，仅 1 例（0.7%）患者行翻修，但在 20 岁以下的 119 例患者中，有 17 例（14.3%）患者行翻修（P<0.0001）。大多数翻修（16/18）发生在 20 岁以下且直径 8mm 或更小的移植物患者中，该人群的翻修率为 16.4%（97 例患者中有 16 例）。重建时年龄小于 20 岁（比值比[OR]，18.97；95%置信区间[CI]，2.43147.06；P=0.005）、移植物尺寸减小（OR，2.20；95%CI，1.004.85；P=0.05）和随访时间延长（OR，1.07；95%CI，1.02~1.12）与翻修风险增加相关。
结论
腘绳肌腱移植物尺寸减小和患者年龄减小是早期移植物翻修的预测因素。在 20 岁以下的患者中使用直径 8mm 或更小的腘绳肌腱移植物与更高的翻修率相关。
证据等级
III 级，回顾性比较研究。
Zotero 插件