Sahlgrenska Sports Medicine Center, Gothenburg, Sweden.
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Br J Sports Med. 2022 Aug;56(15):862-869. doi: 10.1136/bjsports-2021-105115. Epub 2022 Apr 8.
To compare the proportion of patients with anterior cruciate ligament (ACL) injury reporting an acceptable symptom state, between non-surgical and surgical treatment during a 10-year follow-up.
Data were extracted from the Swedish National Knee Ligament Registry. Exceeding the Patient Acceptable Symptom State (PASS) for the Knee injury and Osteoarthritis Outcome Score (KOOS) was the primary outcome. The PASS and KOOS (aggregated KOOS without the activities of daily living (ADL) subscale) were compared cross-sectionally at baseline and 1, 2, 5 and 10 years after ACL injury, where patients treated non-surgically were matched with the maximum number of patients with ACL reconstruction for age, sex and activity at injury.
The non-surgical group consisted of 982 patients, who were each matched against 9 patients treated with ACL reconstruction (n=8,838). A greater proportion of patients treated with ACL reconstruction exceeded the PASS in KOOS pain, ADL, sports and recreation, and quality of life compared with patients treated non-surgically at all follow-ups. With respect to quality of life, significantly more patients undergoing ACL reconstruction achieved a PASS compared with patients receiving non-surgical treatment at all follow-ups except at baseline, with differences ranging between 11% and 25%; 1 year -25.4 (-29.1; -21.7), 2 years -16.9 (-21.2; -12.5), 5 years -11.0 (-16.9; -5.1) and 10 years -24.8 (-36.0; -13.6). The ACL-reconstructed group also reported statistically greater KOOS at all follow-ups.
A greater proportion of patients treated with ACL reconstruction report acceptable knee function, including higher quality of life than patients treated non-surgically at cross-sectional follow-ups up to 10 years after the treatment of an ACL injury.
比较 10 年随访中，非手术治疗和手术治疗的前交叉韧带（ACL）损伤患者报告可接受症状状态的比例。
数据从瑞典膝关节韧带登记处提取。超过膝关节损伤和骨关节炎结果评分（KOOS）的可接受症状状态（PASS）是主要结局。在 ACL 损伤后 1、2、5 和 10 年进行了基线和横截面比较，其中非手术治疗的患者与 ACL 重建的最大数量的患者相匹配，匹配因素包括年龄、性别和损伤时的活动水平。
非手术组包括 982 例患者，每位患者与 9 例 ACL 重建患者（n=8838）相匹配。与非手术治疗相比，在所有随访中，接受 ACL 重建的患者在 KOOS 疼痛、ADL、运动和娱乐以及生活质量方面超过 PASS 的比例更高。就生活质量而言，与接受非手术治疗的患者相比，接受 ACL 重建的患者在所有随访中除基线外都更有可能达到 PASS，差异在 11%至 25%之间；1 年-25.4（-29.1；-21.7），2 年-16.9（-21.2；-12.5），5 年-11.0（-16.9；-5.1）和 10 年-24.8（-36.0；-13.6）。ACL 重建组在所有随访中报告的 KOOS 也更高。
在 ACL 损伤治疗后 10 年的横截面随访中，与非手术治疗相比，接受 ACL 重建的患者报告有可接受的膝关节功能，包括更高的生活质量。
