前交叉韧带重建术中限制从受伤到手术期间的体育活动及时间的重要性。
Importance of Restricting Sportive Activity and Time from Injury to Surgery in Anterior Cruciate Ligament Reconstruction.
作者信息
Ercin Ersin, Gokhan Bilgili M, Atbasi Zafer, Tanriverdi Bulent, Hakan Basaran S, Kural Cemal
机构信息
Department of Orthopaedics and Traumatology, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Department of Orthopaedics and Traumatology, Ankara Mevki, Military Hospital, Ankara, Turkey.
出版信息
Open Orthop J. 2015 Aug 31;9:427-31. doi: 10.2174/1874325001509010427. eCollection 2015.
OBJECTIVES
It is unclear that how long reconstruction may be delayed before additional intraarticular injuries occur. Our aim was to determine the relationship of time period from injury to surgery with the incidence of meniscal and chondral injuries recorded at the time of surgical treatment for ACL tears. The effect of sportive activity restriction, grade of chondral lesions and their locations were also evaluated.
PATIENTS AND METHODS
213 patients who underwent arthroscopic anterior cruciate ligament reconstruction were evaluated retrospectively. Data were analyzed for association between time period before surgery and patients sportive activity restriction with rates of meniscal and chondral injuries. According to time from initial trauma to surgery less than 12 months grouped as group I (101 patients) and 12 months and longer defined as group II (81 patients). Patients who had surgery before 12 months were divided into groups of smaller time scales (0 to 3 months, 4 to 6 months, 7 to 9 months, 10 to 12 months) to examine the relationships more closely. For sportive activity restriction a functional scale was used that described restricted activities including military training.
RESULTS
One hundred eighty-two patients were included to the study. 81 patients restricted sportive activity before surgery. 18 (% 22.2) of these patients had chondral injury [6 (% 33.3) operated before 12 months and 12 (% 66.7) operated after 12 months]. The difference was statistically significant (p=0,005). 81 patients (group II) were operated after 12 months. There were 44 (% 54.3) patients with chondral injury in this group [32 (% 72.7) patients were who continued their sportive activity and 12 (% 27.3) patients who restricted their sportive activity]. The difference was statistically significant (p=0,026). Correlation analysis showed that with increasing time from initial trauma to surgery chondral lesion incidence and grade of these lesions increases (p<0,001, p=0,001).
CONCLUSION
The results indicate that the prolonged time from injury to surgery and continuing sportive activity before surgery increases the incidence of the chondral lesions. Also, time limit of 12 month is important to prevent chondral injury in anterior cruciate ligament reconstruction.
目的
目前尚不清楚在出现额外的关节内损伤之前，重建手术可能会延迟多长时间。我们的目的是确定从受伤到手术的时间段与前交叉韧带撕裂手术治疗时记录的半月板和软骨损伤发生率之间的关系。还评估了运动活动限制、软骨损伤分级及其位置的影响。
患者与方法
对213例行关节镜下前交叉韧带重建术的患者进行回顾性评估。分析手术前时间段与患者运动活动限制与半月板和软骨损伤发生率之间的关联。根据从初次创伤到手术的时间，少于12个月的分为I组（101例患者），12个月及以上的定义为II组（81例患者）。将在12个月前接受手术的患者进一步分为更小时间尺度的组（0至3个月、4至6个月、7至9个月、10至12个月），以更密切地研究两者之间的关系。对于运动活动限制，使用了一个功能量表，该量表描述了包括军事训练在内的受限活动。
结果
182例患者纳入研究。81例患者在手术前限制了运动活动。其中18例（22.2%）患者有软骨损伤[6例（33.3%）在12个月前接受手术，12例（66.7%）在12个月后接受手术]。差异具有统计学意义（p = 0.005）。81例患者（II组）在12个月后接受手术。该组中有44例（54.3%）患者有软骨损伤[32例（72.7%）患者继续进行运动活动，12例（27.3%）患者限制了运动活动]。差异具有统计学意义（p = 0.026）。相关性分析表明，从初次创伤到手术的时间越长，软骨损伤的发生率及其损伤分级越高（p < 0.001，p = 0.001）。
结论
结果表明，从受伤到手术的时间延长以及手术前继续进行运动活动会增加软骨损伤的发生率。此外，12个月的时间限制对于预防前交叉韧带重建术中的软骨损伤很重要。
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