Department of Orthopaedic Surgery, National University Hospital Sports Centre, National University Health System, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore, 119288, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore.
Knee Surg Sports Traumatol Arthrosc. 2019 Mar;27(3):893-897. doi: 10.1007/s00167-018-5168-z. Epub 2018 Sep 29.
Increased knee pain at the time of anterior cruciate ligament (ACL) reconstruction may predict increased pain post-operatively, a prolonged recovery and a more difficult rehabilitation. The main objective of our study was to identify preoperative factors, such as concomitant intra-articular injuries and bone bruises, that may be associated with increased knee pain and symptoms in patients undergoing ACL reconstruction.
Patient data was queried from our institution's prospectively maintained ACL reconstruction registry. Two-hundred and seventy patients who underwent primary ACL reconstruction within 3 months of injury were included in the study. Predictors such as demographic characteristics (age, body mass index and gender) and injury characteristics (mechanism of injury, meniscal injury, chondral injury and bone bruise) were recorded. The association between the pre-operative knee injury and Osteoarthritis Outcome Score (KOOS) pain and symptom subscales and the Short Form-36 (SF-36) bodily pain subscale, and the predictors were assessed using logistic regression for categorical variables and linear regression for continuous variables.
The mean age of our patient group was 25.4 years with 211 out of 270 (78%) being males. Bone bruise was present in 243 patients (90%), meniscal injury in 165 (61%) patients and chondral injury in 40 (15%) patients. The presence of bone bruise, meniscal injury or chondral injury was not significantly associated with worse preoperative KOOS pain and symptom and SF-36 bodily pain scores. Other factors that were not associated were demographic characteristics (age, BMI and gender) and mechanism of injury.
The presence of bone bruise and concomitant intra-articular injuries does not affect pre-operative knee pain and symptoms in patients undergoing ACL reconstruction within 3 months of injury. This knowledge would aid the surgeon in pre-operative counselling, and prognostication of post-operative pain and rehabilitation after ACL reconstruction.
前交叉韧带（ACL）重建时膝关节疼痛增加可能预示术后疼痛增加、恢复时间延长和康复更困难。我们研究的主要目的是确定术前因素，如伴有关节内损伤和骨瘀伤，这些因素可能与 ACL 重建患者膝关节疼痛和症状增加有关。
从我们机构前瞻性维护的 ACL 重建登记处查询患者数据。纳入了 270 名在受伤后 3 个月内接受初次 ACL 重建的患者。记录了预测因素，如人口统计学特征（年龄、体重指数和性别）和损伤特征（损伤机制、半月板损伤、软骨损伤和骨瘀伤）。使用逻辑回归对分类变量和线性回归对连续变量评估术前膝关节损伤与骨关节炎结局评分（KOOS）疼痛和症状子量表以及简明健康调查量表-36（SF-36）身体疼痛子量表之间的关联以及预测因素。
我们患者组的平均年龄为 25.4 岁，270 名患者中有 211 名（78%）为男性。243 名患者（90%）存在骨瘀伤，165 名（61%）患者存在半月板损伤，40 名（15%）患者存在软骨损伤。骨瘀伤、半月板损伤或软骨损伤的存在与术前 KOOS 疼痛和症状以及 SF-36 身体疼痛评分无显著相关性。其他不相关的因素包括人口统计学特征（年龄、BMI 和性别）和损伤机制。
在受伤后 3 个月内接受 ACL 重建的患者中，骨瘀伤和伴有关节内损伤的存在并不影响术前膝关节疼痛和症状。这些知识将有助于外科医生进行术前咨询和预测 ACL 重建后的术后疼痛和康复。
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