Csintalan Rick P, Inacio Maria C S, Desmond Jamie L, Funahashi Tadashi T
Department of Orthopedics, Southern California Permanente Medical Group, Orange County, Irvine, California, USA.
J Knee Surg. 2013 Aug;26(4):225-32. doi: 10.1055/s-0032-1329235. Epub 2012 Nov 6.
Both nonoperative and operative treatments for anterior cruciate ligament (ACL) deficient knees in skeletally immature patients have reported potentially negative outcomes. This study describes primary ACL reconstruction patients with open physes and their concurrent injuries and evaluates whether these patients are at a higher early risk of revision and reoperation than closed physes patients. A retrospective analysis of prospectively collected data was performed. Patients were identified using an ACL Reconstruction Registry. Summary statistics comparing open and closed physes patients of similar ages in regard to patient characteristics and incidence of early revision and reoperation are provided. Adjusted Cox regression models assessed risk of early revision and reoperation for open physes patients. Of 1,867 patients identified, 232 (12.4%) patients had open physes and 1,635 (87.6%) patients had closed physes. Patients with open physes were younger, less likely to be women, and had less medial meniscal injuries than closed physes patients. No significant differences were observed in cartilage injury, overall menisci injury and repair, and early revision and reoperation rate. According to the our results, no significant differences in risk of early revision or early reoperation in open physes compared with closed physes patients when adjusting for age were observed, nor were there any reoperations for physeal closure.
对于骨骼未成熟患者的前交叉韧带（ACL）损伤膝关节，非手术和手术治疗均报告了潜在的负面结果。本研究描述了骨骺未闭合的初次ACL重建患者及其并发损伤，并评估这些患者与骨骺已闭合的患者相比，早期翻修和再次手术的风险是否更高。对前瞻性收集的数据进行了回顾性分析。使用ACL重建登记处识别患者。提供了比较相似年龄的骨骺未闭合和已闭合患者的患者特征以及早期翻修和再次手术发生率的汇总统计数据。调整后的Cox回归模型评估了骨骺未闭合患者早期翻修和再次手术的风险。在识别出的1867例患者中，232例（12.4%）患者骨骺未闭合，1635例（87.6%）患者骨骺已闭合。与骨骺已闭合的患者相比，骨骺未闭合的患者更年轻，女性比例更低，内侧半月板损伤更少。在软骨损伤、半月板总体损伤和修复以及早期翻修和再次手术率方面未观察到显著差异。根据我们的结果，在调整年龄后，观察到骨骺未闭合患者与骨骺已闭合患者在早期翻修或早期再次手术风险方面无显著差异，也没有因骨骺闭合而进行的再次手术。
