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多韧带膝关节损伤后重返运动损伤前水平的低回报率——多韧带膝关节损伤后的功能结果。

Low rate of return to pre-injury level of sports after multi-ligament knee injury - Functional outcomes after MLKI.

机构信息

Department of Orthopaedic surgery, St. Antonius Hospital, P.O. Box 2500, 3430 EM Nieuwegein, the Netherlands; Department of Rehabilitation & Sports Medicine, University Medical Centre Utrecht, PO Box 85500, 3508 GA, Utrecht, the Netherlands.

Department of Orthopaedic surgery, St. Antonius Hospital, P.O. Box 2500, 3430 EM Nieuwegein, the Netherlands; Cohesie, Occupational Health Service, Baron van Nagellstraat 9, 3781 AP Voorthuizen, the Netherlands.

出版信息

Knee. 2021 Dec;33:65-72. doi: 10.1016/j.knee.2021.08.036. Epub 2021 Sep 21.

Abstract

BACKGROUND

Multi-ligament knee injury (MLKI) is a rare but severe injury with potential devastating complications. The primary goal of this study was to investigate return to sports and work after MLKI. Secondary outcomes were patient reported outcome measures (PROMs), treatment, time between trauma, diagnosis and treatment, and neurovascular damage.

METHOD

A database search was performed to identify all patients with MLKI in our hospital (2010-2017). Pre-defined variables were collected from patient files and questionnaires. Multiple regression analysis was used to study the relationship between different variables and PROMs.

RESULTS

31 patients were included. The overall return to sports rate after a MLKI was 88.5%, but only 23.1% returned to their pre-injury level. 83.3% of the patients were able to return to work. Multiple regression analyses led to a significant prediction model for pain during rest (F(7,16) = 2.808, p = 0.041, R = 0.355). Within this model, a higher age was a significant predictor for higher pain scores (p = 0.002). Age was also a significant (negative) predictor within the non-significant models for IKDC (p = 0.004) and Lysholm (p = 0.024). A delay between trauma and diagnosis of more than three months was seen in 32.3% of the patients.

CONCLUSIONS

This study showed a relatively high overall return to sports and work after MLKI, but less than a quarter returned to their pre-injury level of sports. An important finding was the substantial number of patients with a delay between trauma and diagnosis. This study contributes to more awareness and knowledge about MLKI among physicians, which is essential to reduce these delays.

摘要

背景

多韧带膝关节损伤(MLKI)是一种罕见但严重的损伤,可能导致严重的并发症。本研究的主要目的是调查 MLKI 后的运动和工作恢复情况。次要结局指标为患者报告的结果测量(PROMs)、治疗方法、创伤、诊断和治疗之间的时间以及神经血管损伤。

方法

对我院(2010-2017 年)所有 MLKI 患者进行数据库检索。从患者病历和问卷调查中收集预定义变量。采用多元回归分析研究不同变量与 PROMs 的关系。

结果

共纳入 31 例患者。MLKI 后总体运动恢复率为 88.5%,但仅有 23.1%恢复到伤前水平。83.3%的患者能够重返工作岗位。多元回归分析得出了一个用于休息时疼痛的显著预测模型(F(7,16)=2.808,p=0.041,R=0.355)。在该模型中,年龄较高是疼痛评分较高的显著预测因素(p=0.002)。年龄也是 IKDC(p=0.004)和 Lysholm(p=0.024)非显著模型中显著(负)的预测因素。32.3%的患者在创伤和诊断之间存在超过 3 个月的延迟。

结论

本研究显示 MLKI 后总体运动和工作恢复率较高,但只有不到四分之一的患者能恢复到伤前运动水平。一个重要的发现是相当数量的患者存在创伤和诊断之间的延迟。本研究有助于提高医生对 MLKI 的认识和了解,从而减少这些延迟。

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