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非运动相关多韧带膝关节损伤延迟手术重建的功能结果:一项回顾性队列研究。

The Functional Outcomes of Delayed Surgical Reconstruction in Nonsport-Induced Multiligament Knee Injuries: A Retrospective Cohort Study.

机构信息

Department of Orthopedics, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran, Iran.

出版信息

J Knee Surg. 2022 Aug;35(10):1097-1105. doi: 10.1055/s-0040-1721788. Epub 2021 Jan 3.

Abstract

Multiligament knee injuries (MLKIs) are among the most detrimental injuries, which can cause significant compromise of joint stability and function. Our aim was to investigate the functional outcomes of nonsport-induced MLKIs who presented late after injury and underwent delayed arthroscopic reconstruction. In a retrospective cohort of 18 MLKI patients (19 knees, January 2012-2018) who had undergone arthroscopic reconstruction, we assessed the knee range of motion, return to work/sport, International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Arthritis Index, Lysholm, and Tegner scores. The preoperative scores were retrieved from the patients' registry database. We reviewed their surgical notes and extracted the operation data, including the damaged ligaments, stages of the surgery, and associated meniscal injury. There were 14 males and 4 females with a mean age of 30.57 ± 10.31 years. The mean time from injury to surgery was 17.31 ± 11.98 months. The most common injury was anterior cruciate ligament/posterior cruciate ligament (31.6%). The mechanisms of injury were motor vehicle accidents (72.2%), falls (22.2%), and sports (5.6%). The reconstruction was either single (61.2%) or multiple stage (38.8%). The pre- and postoperative scores were 45.31 ± 7.30 versus 79.16 ± 11.86 IKDC, 3.84 ± 1.26 versus 8.37 ± 1.16 Tegner, and 60.42 ± 7.68 versus 89.42 ± 8.81 Lysholm, respectively. All the scores showed significant improvement at mean follow-up of 24.05 ± 9.55 months ( < 0.001). In conclusion, delayed arthroscopic reconstruction of MLKIs significantly improved the functional outcomes and return to work in patients presenting late to the orthopaedic clinic. There was no relationship between the demographic variables, mechanism of injury, number of injured ligaments, and the stages of surgery and the functional outcomes in this group of patients.

摘要

多韧带膝关节损伤(MLKI)是最具破坏性的损伤之一,可导致关节稳定性和功能显著受损。我们的目的是研究受伤后延迟就诊并接受延迟关节镜重建的非运动相关 MLKI 的功能结果。在 2012 年至 2018 年接受关节镜重建的 18 例 MLKI 患者(19 膝)的回顾性队列中,我们评估了膝关节活动范围、重返工作/运动、国际膝关节文献委员会(IKDC)评分、膝关节损伤和骨关节炎结果评分(KOOS)、西安大略和麦克马斯特大学关节炎指数(WOMAC)、Lysholm 评分和 Tegner 评分。术前评分从患者的登记数据库中获得。我们查阅了他们的手术记录并提取了手术数据,包括损伤的韧带、手术阶段以及相关的半月板损伤。患者中有 14 名男性和 4 名女性,平均年龄为 30.57±10.31 岁。从受伤到手术的平均时间为 17.31±11.98 个月。最常见的损伤是前交叉韧带/后交叉韧带(31.6%)。受伤机制为机动车事故(72.2%)、跌倒(22.2%)和运动(5.6%)。重建方式为单阶段(61.2%)或多阶段(38.8%)。术前和术后评分分别为 45.31±7.30 与 79.16±11.86 的 IKDC、3.84±1.26 与 8.37±11.16 的 Tegner 以及 60.42±7.68 与 89.42±8.81 的 Lysholm。平均随访 24.05±9.55 个月后,所有评分均显著改善( <0.001)。总之,对于延迟就诊于骨科诊所的患者,延迟关节镜重建 MLKI 可显著改善功能结果和重返工作。在这群患者中,人口统计学变量、损伤机制、损伤的韧带数量以及手术阶段与功能结果之间没有关系。

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