Chalatsis Georgios, Mitrousias Vasileios, Siouras Athanasios, Panteliadou Freideriki, Tziolas Ioannis, Solomou Chrysovalantis, Hantes Michael
Department of Orthopaedic Surgery & Musculoskeletal Trauma, University Hospital of Larissa, School of Health Sciences, University of Thessaly, Larissa, Greece.
Department of Computer Science and Biomedical Informatics, School of Science, University of Thessaly, Lamia, Greece.
Orthop J Sports Med. 2023 Jun 5;11(6):23259671231177279. doi: 10.1177/23259671231177279. eCollection 2023 Jun.
Long-term studies of patients after anterior cruciate ligament (ACL) reconstruction with or without concomitant meniscal tear treatment are limited.
To (1) report postoperative outcomes after anatomic ACL reconstruction with a hamstring autograft, (2) investigate how concomitant treatment of meniscal injury could affect these outcomes, and (3) evaluate the association between quality of life and activity levels at a minimum 10-year follow-up.
Cohort study; Level of evidence, 3.
Patients treated with a unilateral, anatomic ACL reconstruction between 2005 and 2011 were investigated. The following patient-reported outcome measures (PROMs) were reported for the overall sample as well as a subsample of patients with meniscal injury: International Knee Documentation Committee Subjective Knee Form (IKDC-SKF), Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm knee score, Tegner activity scale, 5-level EQ-5D (EQ-5D-5L), and patient satisfaction. Sex, age, body mass index (BMI), and meniscal injury treatment (meniscectomy vs meniscal repair) were examined as patient-specific risk factors regarding long-term activity and quality of life.
Overall, 106 patients, 90 men (85%) and 16 women (15%), were enrolled in the study, with a mean follow-up of 13.2 years. The ACL retear rate was 2.8%. The mean scores were 80.6 ± 16.7 (IKDC-SKF), 87.4 ± 15.0 (KOOS), 90.5 ± 11.5 (Lysholm), 5.6 ± 1.9 (Tegner), and 91.8 ± 14.5 (EQ-5D-5L). The majority (90.6%) of patients considered their knee state satisfactory during follow-up. When compared with patients who underwent meniscal repair, patients who underwent meniscectomy had statistically significantly lower scores on all PROMs except for the Tegner and EQ-5D-5L ( < .05 for all). The mean difference between the 2 groups was ≥7 points on all PROM scores. Patient sex, age, and BMI did not affect PROM scores. There was a statistically significant, strong positive correlation between quality of life and activity.
Patients had few or no symptoms and considered their knee state satisfactory 13.2 years after anatomic ACL reconstruction. Patients with concomitant meniscal tears having undergone meniscal repair had improved PROMs compared with those treated with meniscectomy. Finally, participation in activities of daily living and sports was interrelated with quality of life and was not affected by patient age, sex, or BMI.
对于前交叉韧带（ACL）重建术后伴或不伴半月板撕裂治疗的患者进行长期研究的情况有限。
（1）报告自体腘绳肌腱解剖重建ACL术后的结果；（2）研究半月板损伤的同期治疗如何影响这些结果；（3）在至少10年的随访中评估生活质量与活动水平之间的关联。
队列研究；证据等级，3级。
对2005年至2011年间接受单侧解剖ACL重建治疗的患者进行调查。报告了总体样本以及半月板损伤患者亚组的以下患者报告结局指标（PROMs）：国际膝关节文献委员会主观膝关节量表（IKDC-SKF）、膝关节损伤和骨关节炎结局评分（KOOS）、Lysholm膝关节评分、Tegner活动量表、5级EQ-5D（EQ-5D-5L）和患者满意度。将性别、年龄、体重指数（BMI）和半月板损伤治疗（半月板切除术与半月板修复）作为关于长期活动和生活质量的患者特异性危险因素进行研究。
总体而言，106例患者纳入研究，其中男性90例（85%），女性16例（15%），平均随访13.2年。ACL再撕裂率为2.8%。平均得分分别为：IKDC-SKF 80.6±16.7、KOOS 87.4±15.0、Lysholm 90.5±11.5、Tegner 5.6±1.9、EQ-5D-5L 91.8±14.5。大多数（90.6%）患者在随访期间认为其膝关节状态满意。与接受半月板修复的患者相比，接受半月板切除术的患者在除Tegner和EQ-5D-5L之外的所有PROMs上得分在统计学上显著更低（所有P<0.05）。两组在所有PROM得分上的平均差异≥7分。患者的性别、年龄和BMI不影响PROM得分。生活质量与活动之间存在统计学上显著的强正相关。
解剖重建ACL术后13.2年，患者很少或没有症状，且认为其膝关节状态满意。与接受半月板切除术的患者相比，半月板撕裂同期接受半月板修复的患者PROMs有所改善。最后，参与日常生活活动和运动与生活质量相关，且不受患者年龄、性别或BMI的影响。
