Sports Surgery Clinic, Santry, Dublin, Ireland.
Sports Surgery Clinic, Santry, Dublin, Ireland.
Knee. 2022 Aug;37:87-94. doi: 10.1016/j.knee.2022.05.013. Epub 2022 Jun 18.
There is an increased risk of anterior cruciate ligament (ACL) rupture and subsequent ACL reconstruction in patients <18 years old due to their high levels of sporting participation.
The purpose of this study was to assess the rate and timing of return to play (RTP) in paediatric and adolescent patients following ACL reconstruction, and to compare the outcomes between those undergoing ACL reconstruction with bone patella tendon bone autograft (BTB) and hamstring tendon (HT) autograft.
Level of Evidence: Level III; Retrospective Comparative Cohort Study.
The institutional ACL registry was screened for patients <18 that had undergone a primary ACL reconstruction. Outcomes were analysed for patients undergoing either a BTB or HT autograft for rate and timing of return to play, functional outcomes and subsequent knee injuries. Statistical analysis was performed using SPSS.
358 (BTB; 253, HT; 105) patients were followed up for 24-months (95% follow up). 86 athletes (27 BTB; 59 HT) were aged 13-15 years old with no significant difference in RTP rate or timing between graft types, however, there was a difference in ipsilateral re-ruptures (10.2% HT vs 0% BTB p = 0.03). 272 athletes (226 BTB; 46 HT) were aged 16-18 years old with no significant difference in RTP rate or timing between graft types, or ipsilateral re-ruptures (8.7% HT vs 2.7% BTB p = 0.07). Concurrent ligament, meniscal or chondral injuries found at the time was treated as necessary.
Paediatric and adolescent patients undergoing ACL reconstruction with either BTB or HT had high rates of return to play. This was seen in both subgroups with 13-15-year-olds mostly receiving a HT graft repair and 16-18-year-olds mainly receiving a BTB repair. A moderate re-rupture rate was seen at 24-months. However longer follow up is needed to truly see the long-term impact of such an injury at such a young age.
由于青少年参与体育运动的水平较高，18 岁以下的前交叉韧带（ACL）撕裂和随后的 ACL 重建的风险增加。
本研究旨在评估 ACL 重建后儿童和青少年患者重返赛场（RTP）的速度和时间，并比较接受骨髌腱骨自体移植物（BTB）和腘绳肌腱（HT）自体移植物重建 ACL 的患者的结果。
证据水平：III 级；回顾性比较队列研究。
筛选机构 ACL 登记处接受初次 ACL 重建的<18 岁患者。分析接受 BTB 或 HT 自体移植物的患者的 RTP 速度和时间、功能结果和随后的膝关节损伤。使用 SPSS 进行统计分析。
358 名（BTB；253 名，HT；105 名）患者接受了 24 个月的随访（95%随访）。86 名运动员（27 名 BTB；59 名 HT）年龄在 13-15 岁之间，两种移植物类型的 RTP 率或时间无显著差异，但同侧再撕裂率不同（10.2%HT 比 0%BTB p=0.03）。272 名运动员（226 名 BTB；46 名 HT）年龄在 16-18 岁之间，两种移植物类型或同侧再撕裂率无显著差异（8.7%HT 比 2.7%BTB p=0.07）。同时发现的韧带、半月板或软骨损伤根据需要进行治疗。
接受 BTB 或 HT 重建 ACL 的儿童和青少年患者的 RTP 率较高。在 13-15 岁的患者中，大多数接受 HT 移植物修复，而 16-18 岁的患者主要接受 BTB 修复，这两个亚组都可以看到这一点。24 个月时观察到中度再撕裂率。然而，需要更长时间的随访才能真正了解如此年轻的患者发生此类损伤的长期影响。
