Department of Sports Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Orthopaedic Surgery, Hospital Tengku Ampuan Rahimah Klang, Ministry of Health, Selangor, Malaysia.
Sci Rep. 2018 Jun 15;8(1):9186. doi: 10.1038/s41598-018-27595-8.
Comparing to primary surgery, revision ACL reconstruction is more technically demanding and has a higher failure rate. Theoretically, rehabilitation can improve knee function after ACL reconstruction surgery. This study aimed to compare knee stability, strength, and function between primary and revision ACL reconstructed knees. 40 primary and 40 revision ACL reconstruction surgeries were included between April 2013 and May 2016. Patients with revision surgery had a higher anteroposterior translation comparing those with primary reconstruction (median laxity, 2.0 mm vs. 3.0 mm, p = 0.0022). No differences were noted in knee extensor at 60°/sec or 180°/sec (p = 0.308, p = 0.931, respectively) or in flexor muscle strength at 60°/sec or 180°/sec between primary and revision ACL reconstruction knees (p = 0.091, p = 0.343, respectively). There were also no significant differences between functional scores including IKDC score and Lysholm score in primary versus revision surgeries at 12th months after index operation (p = 0.154, p = 0.324, respectively). In conclusion, despite having higher anteroposterior instability, patients with revision ACL reconstruction can have non-inferior outcomes in isokinetic knee strength and function compared to those with primary ACL reconstruction after proper rehabilitation.
与初次手术相比,ACL 翻修重建手术技术要求更高,失败率更高。理论上,康复可以改善 ACL 重建手术后的膝关节功能。本研究旨在比较初次和翻修 ACL 重建膝关节的膝关节稳定性、力量和功能。纳入 2013 年 4 月至 2016 年 5 月期间的 40 例初次 ACL 重建和 40 例翻修 ACL 重建手术。与初次重建相比,翻修手术的患者的前向和后向平移更大(中位数松弛度,2.0mm 比 3.0mm,p=0.0022)。初次和翻修 ACL 重建膝关节的伸膝在 60°/秒或 180°/秒时的肌肉力量(p=0.308,p=0.931)或屈膝在 60°/秒或 180°/秒时的肌肉力量(p=0.091,p=0.343)无差异。初次和翻修 ACL 重建膝关节在术后 12 个月的 IKDC 评分和 Lysholm 评分等功能评分方面也无显著差异(p=0.154,p=0.324)。总之,尽管翻修 ACL 重建患者的前向和后向不稳定性更高,但经过适当的康复,他们在等速膝关节力量和功能方面与初次 ACL 重建患者的结果相当。