Rahardja Richard, Zhu Mark, Love Hamish, Clatworthy Mark G, Monk Andrew Paul, Young Simon W
University of Auckland, Auckland, New Zealand.
University of Auckland, Auckland, New Zealand; Department of Orthopaedic Surgery, Auckland Hospital, Auckland, New Zealand.
Knee. 2020 Mar;27(2):287-299. doi: 10.1016/j.knee.2019.12.003. Epub 2020 Jan 31.
To identify the patient and surgical factors associated with revision anterior cruciate ligament (ACL) reconstruction as reported by all national and community ACL registries.
A systematic review was performed on the MEDLINE, Embase and Cochrane Library databases. Eligibility criteria included English studies published by national or community ACL registries reporting on primary ACL reconstruction and risk factors associated with revision ACL reconstruction.
Thirty-three studies from the Swedish, Norwegian, Danish and Kaiser Permanente registries were included for review. Fourteen studies from all four registries reported younger age as a risk factor for revision ACL reconstruction. In addition, the Swedish registry reported concomitant medial collateral ligament (MCL) injury, undergoing earlier surgery, lower Knee Injury and Osteoarthritis Outcome Score (KOOS), smaller graft diameter and an anteromedial portal drilling technique as risk factors for revision. The risk factors reported by the Norwegian registry included lower body mass index (BMI), lower KOOS, hamstring tendon grafts and suspensory fixation. The Danish registry reported hamstring tendon grafts, anteromedial portal drilling and suspensory fixation as risk factors. The Kaiser Permanente registry reported male sex, lower BMI, ethnicity, hamstring tendon grafts, allografts, smaller graft diameter and an anteromedial portal technique as risk factors for revision.
Multiple patient and surgical factors were associated with increased risk of revision ACL reconstruction in registries. Younger age and the use of hamstring tendon grafts were consistently reported as risk factors for failure.
确定所有国家和社区前交叉韧带（ACL）登记处报告的与翻修ACL重建相关的患者和手术因素。
对MEDLINE、Embase和Cochrane图书馆数据库进行系统评价。纳入标准包括国家或社区ACL登记处发表的英文研究，报告初次ACL重建以及与翻修ACL重建相关的危险因素。
纳入了来自瑞典、挪威、丹麦和凯撒医疗集团登记处的33项研究进行综述。所有四个登记处的14项研究报告称年龄较小是翻修ACL重建的危险因素。此外，瑞典登记处报告合并内侧副韧带（MCL）损伤、手术较早、膝关节损伤和骨关节炎疗效评分（KOOS）较低、移植物直径较小以及采用前内侧入路钻孔技术是翻修的危险因素。挪威登记处报告的危险因素包括较低的体重指数（BMI）、较低的KOOS、腘绳肌腱移植物和悬吊固定。丹麦登记处报告腘绳肌腱移植物、前内侧入路钻孔和悬吊固定是危险因素。凯撒医疗集团登记处报告男性、较低的BMI、种族、腘绳肌腱移植物、同种异体移植物、较小的移植物直径和前内侧入路技术是翻修的危险因素。
登记处中多种患者和手术因素与翻修ACL重建风险增加相关。年龄较小和使用腘绳肌腱移植物一直被报告为失败的危险因素。
