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.
Knee Surg Sports Traumatol Arthrosc. 2021 Nov;29(11):3864-3870. doi: 10.1007/s00167-020-06417-3. Epub 2021 Jan 23.
To evaluate and compare knee laxity and functional knee outcome between primary and contralateral anterior cruciate ligament (ACL) reconstruction.
Patients who underwent primary and subsequent contralateral ACL reconstruction (ACLR) at Capio Artro Clinic, Stockholm, Sweden, from 2001 to 2017, were identified in our local database. The inclusion criteria were: the same patients who underwent primary and contralateral hamstring tendon or bone-patellar tendon-bone autograft ACLR and no associated ligament injuries. The KT-1000 arthrometer, with an anterior tibial load of 134 N, was used to evaluate knee laxity preoperatively and 6 months postoperatively. The Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and at the 1-year follow-up.
A total of 326 patients with isolated primary and contralateral ACLR met the inclusion criteria (47.9% males; mean age at primary ACLR 23.9 ± 9.4 years and contralateral ACLR 27.9 ± 10.1 years). The arthrometric laxity measurements were available for primary and contralateral ACLR for 226 patients. The mean preoperative and postoperative anterior tibial translation (ATT), as well as the mean ATT reduction from preoperatively to postoperatively, did not differ significantly between primary and contralateral ACLR. The KOOS was available for primary and contralateral ACLR for 256 patients. No significant differences were found preoperatively and at the 1-year follow-up between primary and contralateral ACLR for any of the five KOOS subscales.
The findings in this study showed that anterior knee laxity and functional knee outcome after contralateral ACLR are comparable to those after primary ACLR. It is important for clinicians to counsel patients about their expectations after contralateral ACLR. This study shows that the results after contralateral ACLR in terms of knee laxity and functional knee outcome are predictable and likely to be comparable to those after primary ACLR.
Level III.
评估和比较初次与对侧前交叉韧带(ACL)重建之间的膝关节松弛度和功能膝关节结果。
在瑞典斯德哥尔摩的 Capio Artro 诊所,我们从 2001 年至 2017 年确定了接受初次和随后对侧 ACL 重建(ACLR)的患者。纳入标准为:接受初次和对侧腘绳肌腱或骨-髌腱-骨自体移植物 ACLR 且无相关韧带损伤的同一患者。使用 KT-1000 关节测量仪,在 134 N 的胫骨前负荷下,在术前和术后 6 个月评估膝关节松弛度。术前和 1 年随访时收集膝关节损伤和骨关节炎结果评分(KOOS)。
共有 326 例单独初次和对侧 ACLR 患者符合纳入标准(男性占 47.9%;初次 ACLR 时的平均年龄为 23.9±9.4 岁,对侧 ACLR 时的平均年龄为 27.9±10.1 岁)。226 例患者可提供初次和对侧 ACLR 的关节测量松弛度测量值。初次和对侧 ACLR 的术前和术后胫骨前移位(ATT)平均值以及从术前到术后的 ATT 平均减少量均无显著差异。256 例患者可提供初次和对侧 ACLR 的 KOOS。初次和对侧 ACLR 在术前和 1 年随访时的五个 KOOS 亚量表中均无显著差异。
本研究结果表明,对侧 ACLR 后的膝关节前侧松弛度和膝关节功能结果与初次 ACLR 后相似。临床医生应向患者提供有关对侧 ACLR 后预期的咨询。本研究表明,对侧 ACLR 后在膝关节松弛度和膝关节功能结果方面的结果是可预测的,并且可能与初次 ACLR 后相似。
III 级。