Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Knee Surg Sports Traumatol Arthrosc. 2020 Aug;28(8):2663-2667. doi: 10.1007/s00167-020-05910-z. Epub 2020 Feb 27.
There is paucity in studies regarding double-bundle anterior cruciate ligament reconstruction (DB-ACLR) in teenagers. The purpose of this study is to investigate clinical outcome after DB-ACLR and analyze whether any differences exist between teenagers and young adults.
A retrospective study was performed between 2009 and 2017. Teenagers were defined as patients between 15 and 19 years and young adults between 20 and 25 years old. Isolated anterior cruciate ligament (ACL) injuries with DB-ACLR with minimum two-year follow up were included. Pre and post-operative Lysholm score, Tegner activity scale, KT-2000 arthrometer, manual pivot-shift grade, were assessed with post-operative one-leg hop test, isokinetic knee extensor strength test at 60°/sec, International Knee Documentation Committee Score (IKDC score), and re-injury rate.
One-hundred and thirty-one patients, 75 patients in the teenage group (Group A) and 56 patients in the young adult group (Group B), were enrolled. Lysholm score was significantly lower in Group A (89.6 ± 21.1) compared to Group B (95.9 ± 4.6) (p = 0.04). Side to side difference in KT-2000 arthrometer (2.3 ± 2.2 mm vs 1.0 ± 2.3 mm, Group A vs Group B, respectively, p < 0.01) and ratio of post-operative positive pivot shift was significantly greater in Group A (30.7%) compared to Group B (7.1%) (p < 0.01). No significant difference was seen in re-injury rate (n.s.).
Teenage patients have a greater tendency for residual knee joint laxity after DB-ACLR. Although teenagers and patients in the early twenties are close in age, characteristic in knee joint laxity may be different and, therefore, may require attention upon surgery and post-operative follow-up.
III.
关于青少年双束前交叉韧带重建（DB-ACLR）的研究很少。本研究旨在探讨 DB-ACLR 后的临床疗效，并分析青少年与年轻成人之间是否存在差异。
本研究为 2009 年至 2017 年的回顾性研究。将 15 至 19 岁的患者定义为青少年，20 至 25 岁的患者定义为年轻成人。纳入接受 DB-ACLR 且至少随访 2 年的单纯前交叉韧带（ACL）损伤患者。评估术前和术后的 Lysholm 评分、Tegner 活动量表、KT-2000 关节测量仪、手动前抽屉试验分级、术后单腿跳测试、等速膝关节伸肌力量测试（60°/s）、国际膝关节文献委员会评分（IKDC 评分）和再损伤率。
共纳入 131 例患者，其中 75 例为青少年组（A 组），56 例为年轻成人组（B 组）。A 组 Lysholm 评分（89.6±21.1）明显低于 B 组（95.9±4.6）（p=0.04）。A 组 KT-2000 关节测量仪的侧间差值（2.3±2.2mm 比 1.0±2.3mm，p<0.01）和术后阳性前抽屉试验的比例（30.7%比 7.1%，p<0.01）明显大于 B 组。再损伤率无明显差异（n.s.）。
青少年患者在 DB-ACLR 后膝关节松弛的倾向更大。尽管青少年和 20 岁出头的患者年龄相近，但膝关节松弛的特征可能不同，因此在手术和术后随访时需要注意。
III 级。
