Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Department of Orthopedics, Sahlgrenska University Hospital, Göteborg, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2022 Dec;30(12):4173-4180. doi: 10.1007/s00167-022-07008-0. Epub 2022 Jun 8.
The purpose of this study was to evaluate whether generalized joint hypermobility (GJH) influences postoperative results, including return to sport, patientreported outcomes, functional performance (hop tests), muscular strength, and the occurrence of ACL re-injury, in patients 1 year after anterior cruciate ligament (ACL) reconstruction.
Data was extracted from a regional rehabilitation-specific registry containing information on patients with ACL injury. Patients between the ages of 16-50 years previously undergoing ACL reconstruction with available 1 year follow-up data were eligible for inclusion. Generalized joint hypermobility was assessed using the Beighton score (BS). Patients were examined one year postoperatively in terms of return to sport, patient-reported outcome, hop tests, muscular strength and the occurrence of reinjury. For purpose of analysis, patients were allocated into two groups, depending on the existence of GJH. The KOOS subscale of sports and recreation was considered the primary outcome. Analyses were performed both dichotomously and by using adjusted logistic regression, to consider potential confounders.
A total of 356 patients (41% males) were included, of which 76 (24% male) were categorized as having GJH. Patients with GJH had an inferior limb symmetry index preoperatively in terms of knee extension (mean 81.6 [SD 16.4] vs. 91.4 [SD 15.9], p = 0.02) and flexion strength (mean 91.9 vs. 99.1, p = 0.047) compared to patients without GJH. There was no difference between the groups in terms of the primary outcome, nor in any of the other postoperative outcomes. Nine patients (11.8%) in the group with GJH suffered ACL re-injury, compared with 13 patients (4.6%) in the control group (n.s.).
One year after ACL reconstruction the existence of GJH did not affect postoperative patient satisfaction, strength or functional outcome. No conclusive statements can be made regarding the influence of GJH on the risk of ACL re-injury in this particular study.
Level II.
本研究旨在评估广义关节过度活动（GJH）是否会影响术后结果，包括重返运动、患者报告的结果、功能表现（跳跃测试）、肌肉力量以及 ACL 再损伤的发生，在 ACL 重建后 1 年的患者中。
从包含 ACL 损伤患者信息的区域康复特定注册处提取数据。年龄在 16-50 岁之间、之前接受过 ACL 重建且有 1 年随访数据的患者有资格入选。使用 Beighton 评分（BS）评估广义关节过度活动。术后 1 年对患者进行重返运动、患者报告的结果、跳跃测试、肌肉力量和再损伤的检查。为了分析目的，根据是否存在 GJH，将患者分为两组。KOOS 亚量表的运动和娱乐被认为是主要结果。采用二分法和调整后的逻辑回归进行分析，以考虑潜在的混杂因素。
共纳入 356 名患者（41%为男性），其中 76 名（24%为男性）被归类为存在 GJH。与无 GJH 的患者相比，GJH 患者的膝关节伸展（平均 81.6[SD 16.4]与 91.4[SD 15.9]，p=0.02）和屈曲力量（平均 91.9 与 99.1，p=0.047）术前的下肢对称性指数较低。两组在主要结果和其他术后结果方面均无差异。GJH 组有 9 名患者（11.8%）发生 ACL 再损伤，而对照组有 13 名患者（4.6%）（n.s.）。
ACL 重建后 1 年，GJH 的存在并不影响术后患者满意度、力量或功能结果。在这项特定研究中，不能对 GJH 对 ACL 再损伤风险的影响做出明确的结论。
II 级。
