Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Knee Surg. 2022 Jul;35(8):844-848. doi: 10.1055/s-0040-1721423. Epub 2020 Nov 26.
The incidence of anterior cruciate ligament (ACL) reconstruction is increasing in the United States, particularly in the older athlete. Patients who undergo ACL reconstruction are at higher risk for undergoing total knee arthroplasty (TKA) later in life. TKA in patients with prior ACL reconstruction has been associated with longer operative time due in-part to difficulty with exposure and retained hardware. Outcomes after TKA in patients with prior ACL reconstruction are not well defined, with some reports showing increased rate of complications and higher risk of reoperation compared with routine primary TKA, but these results are based on small and nonrandomized cohorts. Future research is needed to determine whether graft choice or fixation technique for ACL reconstruction influences outcomes after subsequent TKA. Furthermore, whether outcomes are affected by choice of TKA implant design for patients with prior ACL reconstruction warrants further study. This review analyzes the epidemiology, operative considerations, and outcomes of TKA following ACL reconstruction.
在美国，前交叉韧带（ACL）重建的发病率正在增加，尤其是在老年运动员中。接受 ACL 重建的患者在以后的生活中进行全膝关节置换术（TKA）的风险更高。在有 ACL 重建史的患者中，由于显露和残留硬件的困难，TKA 的手术时间往往更长。有 ACL 重建史的患者行 TKA 后的结果尚不清楚，一些报道显示与常规初次 TKA 相比，并发症发生率增加，再次手术的风险更高，但这些结果基于小样本且非随机队列。需要进一步的研究来确定 ACL 重建时移植物的选择或固定技术是否会影响随后 TKA 的结果。此外，对于有 ACL 重建史的患者，TKA 植入物设计的选择是否会影响结果，这值得进一步研究。本综述分析了 ACL 重建后 TKA 的流行病学、手术考虑因素和结果。
