六分之一的前交叉韧带重建术可能会因并发症或新伤在 2 年内再次手术。
One sixth of primary anterior cruciate ligament reconstructions may undergo reoperation due to complications or new injuries within 2 years.
机构信息
Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden.
Capio Artro Clinic, FIFA Medical Centre of Excellence, Sophiahemmet Hospital, Valhallavägen 91, 11486, Stockholm, Sweden.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2020 Aug;28(8):2478-2485. doi: 10.1007/s00167-020-06127-w. Epub 2020 Jun 29.
PURPOSE
To analyse the incidence, types and risk factors for reoperation within 2 years of primary anterior cruciate ligament reconstruction (ACLR).
METHODS
Our clinic registry was used to identify primary ACLRs, performed from 2005 to 2015, and reoperations performed on the ipsilateral knee within 2 years at our institution. Reoperations were identified using procedural codes and analysis of medical records. A logistic regression analysis was used to evaluate risk factors for reoperation.
RESULTS
A total of 6030 primary ACLRs were included. A total of 1112 (18.4%) reoperations performed on 1018 (16.9%) primary ACLRs were identified. The most common reoperations were screw removal (n = 282, 4.7%), meniscus procedures (n = 238, 3.9%), cyclops removal/notchplasty (n = 222, 3.7%) and reoperations due to graft rupture (n = 146, 2.4%), including revision ACLR. Age < 30 years (OR 1.57; 95% CI 1.37-1.80; P < 0.001), female gender (OR 1.33; 95% CI 1.17-1.51; P < 0.001), medial meniscus repair (OR 1.55; 95% CI 1.23-1.97; P < 0.001), lateral meniscus resection (OR 1.26; 95% CI 1.07-1.49; P = 0.005) and lateral meniscus repair (OR 1.38; 95% CI 1.03-1.85; P = 0.02) at primary ACLR were found to be risk factors for reoperation.
CONCLUSION
One sixth of all primary ACLRs underwent reoperation due to complications or new injuries within 2 years. The most common reoperations were screw removal, meniscus procedures, cyclops removal/notchplasty and reoperations due to graft rupture, including revision ACLR. Younger age (< 30 years), female gender, medial meniscus repair and lateral meniscus resection or repair at primary ACLR were associated with an increased risk of reoperation. This study provides clinicians with important data to inform patients about the short-term reoperation rates, the most common reoperation procedures and risk factors for reoperation after primary ACLR.
LEVEL OF EVIDENCE
III.
目的
分析初次前交叉韧带重建（ACLR）后 2 年内再次手术的发生率、类型和危险因素。
方法
本研究使用我们的临床病历数据库，对 2005 年至 2015 年期间在我院进行的初次 ACLR 手术进行了回顾性分析，并对同侧膝关节在 2 年内进行的再次手术进行了分析。再次手术通过手术编码和病历分析来确定。采用逻辑回归分析评估再次手术的危险因素。
结果
共纳入 6030 例初次 ACLR 手术。在 1018 例（16.9%）初次 ACLR 中，共有 1112 例（18.4%）进行了再次手术。最常见的再次手术是螺钉取出（n=282，4.7%）、半月板手术（n=238，3.9%）、前交叉韧带重建术（n=222，3.7%）和因移植物破裂导致的再次手术（n=146，2.4%），包括翻修前交叉韧带重建术。年龄<30 岁（OR 1.57；95%CI 1.37-1.80；P<0.001）、女性（OR 1.33；95%CI 1.17-1.51；P<0.001）、内侧半月板修复（OR 1.55；95%CI 1.23-1.97；P<0.001）、外侧半月板切除术（OR 1.26；95%CI 1.07-1.49；P=0.005）和外侧半月板修复（OR 1.38；95%CI 1.03-1.85；P=0.02）是初次 ACLR 后再次手术的危险因素。
结论
在初次 ACLR 后 2 年内，约六分之一的患者因并发症或新损伤需要再次手术。最常见的再次手术是螺钉取出、半月板手术、前交叉韧带重建术和因移植物破裂导致的再次手术，包括翻修前交叉韧带重建术。年龄较小（<30 岁）、女性、初次 ACLR 时内侧半月板修复和外侧半月板切除术或修复与再次手术风险增加相关。本研究为临床医生提供了重要数据，以便于他们向患者告知初次 ACLR 后短期再次手术率、最常见的再次手术程序和再次手术的危险因素。
证据等级
III。
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