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临床结果和翻修前交叉韧带重建的失败率在 40 岁以下和 40 岁以上的患者之间是可比的:一项至少 2 年随访研究。

Clinical Outcomes and the Failure Rate of Revision Anterior Cruciate Ligament Reconstruction Were Comparable Between Patients Younger Than 40 Years and Patients Older Than 40 Years: A Minimum 2-Year Follow-Up Study.

机构信息

Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Korea.

Department of Orthopedic Surgery, Korea University Ansan Hospital, Gyeongki-do, Korea.

出版信息

Arthroscopy. 2020 Sep;36(9):2513-2522. doi: 10.1016/j.arthro.2020.06.012. Epub 2020 Jun 15.

DOI:10.1016/j.arthro.2020.06.012
PMID:32554076
Abstract

PURPOSE

To compare the clinical outcomes and failure rates of revision anterior cruciate ligament reconstruction (ACLR) between young and middle-aged surgery patients.

METHODS

Patients who underwent revision ACLRs between January 2008 and June 2017 with a minimum 2-year follow-up were retrospectively evaluated. Patients were divided into 2 groups according to age: ≥40 years (group A) and <40 years (group B). Detailed patient demographic data, preoperative radiographic data, and concurrent meniscal and chondral lesion were reviewed. Clinical scores, laxity tests results, and graft failures were compared between groups at the final follow-up.

RESULTS

Eighty-six patients (group A, n = 24, 46.6 ± 4.5 years; group B, n = 62, 26.2 ± 6.3 years) were included in this study. Demographic data showed that the time interval from primary to revision ACLR was longer in group A than in group B (96.2 ± 80.9 vs. 52.0 ± 42.1 months, P = .011). Group A had a higher prevalence of chondral defects of the trochlea (P = .016). No significant differences were identified in the prevalence and severity of meniscal lesions. At the final follow-up, all clinical scores were improved postoperatively but did not differ significantly between the groups. No significant differences were identified in side-to-side difference on Telos stress radiographs (group A, 6.3 ± 5.0 mm; group B, 5.6 ± 3.8 mm; P = .403) and graft failure rate (group A, 33.3%; group B, 30.6%; P = .358) at the final follow-up.

CONCLUSIONS

The current study showed that the clinical outcomes of revision ACLRs in patients improved significantly in patients younger than 40 years and were comparable to those observed in patients older than 40 years at a minimum 2-year follow-up.

LEVEL OF EVIDENCE

III.

摘要

目的

比较年轻和中年手术患者行前交叉韧带重建(ACLR)翻修术的临床结果和失败率。

方法

回顾性评估了 2008 年 1 月至 2017 年 6 月期间接受 ACLR 翻修术且随访时间至少 2 年的患者。根据年龄将患者分为 2 组:≥40 岁(A 组,n=24,46.6±4.5 岁)和<40 岁(B 组,n=62,26.2±6.3 岁)。回顾了详细的患者人口统计学数据、术前影像学数据以及并发的半月板和软骨损伤。在最终随访时比较了两组之间的临床评分、松弛试验结果和移植物失败情况。

结果

本研究纳入了 86 名患者(A 组,n=24,46.6±4.5 岁;B 组,n=62,26.2±6.3 岁)。人口统计学数据显示,A 组从初次 ACLR 到翻修 ACLR 的时间间隔长于 B 组(96.2±80.9 比 52.0±42.1 个月,P=0.011)。A 组滑车的软骨缺损发生率更高(P=0.016)。两组半月板病变的发生率和严重程度无显著差异。在最终随访时,所有临床评分均在术后得到改善,但组间无显著差异。Telos 应激情视片的侧-侧差值(A 组,6.3±5.0mm;B 组,5.6±3.8mm;P=0.403)和移植物失败率(A 组,33.3%;B 组,30.6%;P=0.358)在最终随访时也无显著差异。

结论

本研究表明,在至少 2 年的随访中,<40 岁患者行 ACLR 翻修术的临床结果显著改善,与>40 岁患者相似。

证据水平

III 级。

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