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前交叉韧带重建术后 3 个月出现关节积液与再损伤相关。

Joint effusion at 3 months after anterior cruciate ligament reconstruction is associated with reinjury.

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.

Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2023 May;31(5):1798-1804. doi: 10.1007/s00167-022-07081-5. Epub 2022 Jul 30.

Abstract

PURPOSE

To evaluate whether joint effusion at 3 months after anterior cruciate ligament (ACL) reconstruction is associated with ACL reinjury.

METHODS

The medical records of 227 consecutive patients who underwent single-bundle ACL reconstruction between 2015 and 2018 were reviewed in this retrospective single-center study. Demographic data such as sex and age at surgery, as well as data on preinjury Tegner activity scale score, time from injury to surgery, presence of meniscus and cartilage injuries, and the occurrence of ACL reinjury within 2 years, were collected. Joint effusion was defined as grade 3 (range 0-3) according to the ACL Osteoarthritis Score by magnetic resonance imaging at 3 months postoperatively. Multivariate logistic regression analysis was performed to control for potential confounders.

RESULTS

A total of 176 patients (mean age 22.5 ± 9.9 years) were included. Among these patients, 18 (10.2%) had ACL reinjury. At the multivariate logistic regression analysis, higher Tegner activity scale (odds ratio [OR] 3.12; 95% confidence interval [CI] 1.61-6.04; p < 0.001) and presence of joint effusion (OR 34.5; 95% CI 6.63-179.7; p < 0.001) increased the odds of ACL reinjury, and older age (OR 0.68; 95% CI 0.51-0.92; p = 0.012) decreased the odds of ACL reinjury.

CONCLUSIONS

Joint effusion with a larger fluid volume at 3 months postoperatively was one of the risk factors for ACL reinjury independent of confounders, such as age and activity level. This result suggests the possibility of postoperative intervention for ACL reinjury.

LEVEL OF EVIDENCE

III.

摘要

目的

评估前交叉韧带(ACL)重建后 3 个月时的关节积液是否与 ACL 再损伤有关。

方法

本回顾性单中心研究分析了 2015 年至 2018 年间接受单束 ACL 重建的 227 例连续患者的病历。收集了人口统计学数据,如手术时的性别和年龄,受伤至手术的时间,半月板和软骨损伤的存在,以及术后 2 年内 ACL 再损伤的发生情况。关节积液根据术后 3 个月的 ACL 骨关节炎评分(MRI)定义为 3 级(范围 0-3)。进行多变量逻辑回归分析以控制潜在的混杂因素。

结果

共纳入 176 例患者(平均年龄 22.5±9.9 岁),其中 18 例(10.2%)发生 ACL 再损伤。在多变量逻辑回归分析中,较高的 Tegner 活动量表评分(比值比[OR]3.12;95%置信区间[CI]1.61-6.04;p<0.001)和关节积液的存在(OR 34.5;95%CI 6.63-179.7;p<0.001)增加了 ACL 再损伤的几率,而年龄较大(OR 0.68;95%CI 0.51-0.92;p=0.012)则降低了 ACL 再损伤的几率。

结论

术后 3 个月关节积液量较大是 ACL 再损伤的独立危险因素之一,这一结果提示术后可能需要对 ACL 再损伤进行干预。

证据等级

III。

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