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单束与双束前交叉韧带重建的翻修率无差异:一项对瑞典国家膝关节韧带登记处16791例患者的比较研究。

No difference in revision rates between single- and double-bundle anterior cruciate ligament reconstruction: a comparative study of 16,791 patients from the Swedish national knee ligament register.

作者信息

Björnsson Haukur, Andernord Daniel, Desai Neel, Norrby Olof, Forssblad Magnus, Petzold Max, Karlsson Jón, Samuelsson Kristian

机构信息

Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.

Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Vårdcentralen Gripen, Karlstad, Sweden; Primary Care Research Unit, Centre for Clinical Research, County Council of Värmland, Karlstad, Sweden.

出版信息

Arthroscopy. 2015 Apr;31(4):659-64. doi: 10.1016/j.arthro.2014.11.030. Epub 2015 Jan 21.

Abstract

PURPOSE

The purpose was to compare revision rates and patient-reported outcomes between single- and double-bundle anterior cruciate ligament (ACL) reconstructions.

METHODS

All patients from the Swedish National Knee Ligament Register from 2005 through 2011 who underwent primary ACL reconstruction with hamstring autografts were included. Patients with concomitant injuries, except meniscal and chondral injuries, were excluded. By December 31, 2011, 16,791 primary isolated ACL reconstructions had been registered, of which 16,281 were single-bundle and 510 were double-bundle. Cumulative revision rates were estimated using Kaplan-Meier analysis. The Knee injury and Osteoarthritis Outcome Score (KOOS) and EQ-5D were calculated at 1- and 2-year follow-ups.

RESULTS

The revision rate showed no statistically significant differences between the groups (P = .30). Over the 7-year observation period, 347 single-bundle (2.1%) and 8 double-bundle (1.6%) ACL reconstructions were revised. No significant differences in the KOOS or EQ-5D were found between the groups postoperatively. In addition, there were no differences in postoperative improvements in the KOOS or EQ-5D at 1- and 2-year follow-ups.

CONCLUSIONS

Revision rates after single- and double-bundle ACL reconstructions were low. No differences were found in revision rates, KOOS, and EQ-5D between the 2 techniques.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

摘要

目的

比较单束和双束前交叉韧带(ACL)重建的翻修率及患者报告的结局。

方法

纳入2005年至2011年瑞典国家膝关节韧带登记处所有接受自体腘绳肌腱移植进行初次ACL重建的患者。排除伴有除半月板和软骨损伤之外其他损伤的患者。截至2011年12月31日,共登记了16791例初次孤立性ACL重建,其中16281例为单束重建,510例为双束重建。采用Kaplan-Meier分析估计累积翻修率。在1年和2年随访时计算膝关节损伤和骨关节炎结局评分(KOOS)及EQ-5D。

结果

两组之间的翻修率无统计学显著差异(P = 0.30)。在7年观察期内,347例(2.1%)单束ACL重建和8例(1.6%)双束ACL重建进行了翻修。术后两组之间在KOOS或EQ-5D方面未发现显著差异。此外,在1年和2年随访时,两组在KOOS或EQ-5D的术后改善方面也无差异。

结论

单束和双束ACL重建后的翻修率较低。两种技术在翻修率、KOOS和EQ-5D方面未发现差异。

证据水平

III级,回顾性比较研究。

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