Witoński Dariusz, Kęska Rafał, Cyranowski Rafał, Paradowski Przemysław T
Social Academy of Science, Lodz, Poland.
Department of Orthopaedics, University Clinical Hospital WAM, Lodz, Poland.
Wideochir Inne Tech Maloinwazyjne. 2016;11(2):76-82. doi: 10.5114/wiitm.2016.60044. Epub 2016 May 19.
Several studies have suggested that anterior cruciate ligament reconstruction (ACLR) without wound drainage has no impact on long-term follow-up.
To investigate a prospective patient series as measured by the patient-administered disease-specific questionnaire Knee injury and Osteoarthritis Outcome Score (KOOS).
The study included 101 consecutive patients (71 men and 30 women) with a mean age of 30 years (SD 10, range: 15-62 years), who had undergone primary single incision arthroscopic bone-patellar tendon-bone autograft (BPTB) ACLR without wound drainage. All patients completed KOOS questionnaires, preoperatively and at a mean follow-up of 1.4 years (range: 0.4-3.4). Satisfactory clinical outcome (function recovery - FR) was defined as the lower threshold for the 95% CI of 18-34-year old males and corresponded to a KOOS score > 90 for Pain, 84 for Symptoms, 91 for Activities of Daily Living (ADL), 80 for Sports/Recreation, and 81 for Quality of Life (QOL). A non-satisfactory result was defined as treatment failure (TF) and corresponded to a QOL score < 44.
All patients achieved 90° of knee flexion on the first postoperative day and full extension 2 weeks postoperatively. A full range of motion was achieved in less than 6 weeks postoperatively. No postoperative complications were reported. Score improvement at follow-up was observed in the KOOS subscales Pain, Symptoms and ADL. Criteria for FR were fulfilled by 52% of patients for Pain, 47% for Symptoms, 62% for ADL, 34% for Sports/Recreation and 15% for QOL, whereas criteria for TF were fulfilled by 29% of patients.
The study demonstrated that the primary ACLRs without wound drainage did not have any negative impact for patient-reported recovery.
多项研究表明，前交叉韧带重建术（ACLR）不进行伤口引流对长期随访没有影响。
通过患者自行管理的疾病特异性问卷膝关节损伤和骨关节炎疗效评分（KOOS）来调查一组前瞻性患者。
该研究纳入了101例连续患者（71例男性和30例女性），平均年龄30岁（标准差10，范围：15 - 62岁），他们接受了初次单切口关节镜下骨 - 髌腱 - 骨自体移植（BPTB）ACLR且未进行伤口引流。所有患者在术前及平均随访1.4年（范围：0.4 - 3.4年）时完成了KOOS问卷。满意的临床结果（功能恢复 - FR）定义为18 - 34岁男性95%置信区间的下限，对应KOOS评分：疼痛>90、症状>84、日常生活活动（ADL）>91、运动/娱乐>80、生活质量（QOL）>81。不满意的结果定义为治疗失败（TF），对应QOL评分<44。
所有患者术后第一天膝关节屈曲达到90°，术后2周完全伸直。术后不到6周就实现了全范围活动。未报告术后并发症。随访时KOOS子量表疼痛、症状和ADL的评分有所改善。52%的患者疼痛达到FR标准，47%的患者症状达到标准，62%的患者ADL达到标准，34%的患者运动/娱乐达到标准，15%的患者QOL达到标准，而29%的患者达到TF标准。
该研究表明，不进行伤口引流的初次ACLR对患者报告的恢复没有任何负面影响。
