Yoon Kyung Ho, Park Cheol Hee, Lee Hee Sung, Hwang Sung Hyun
Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Orthop J Sports Med. 2023 Jul 27;11(7):23259671231182124. doi: 10.1177/23259671231182124. eCollection 2023 Jul.
There are no studies on the nonoperative treatment of traumatic partial anterior cruciate ligament (ACL) graft rupture.
PURPOSE/HYPOTHESIS: The purpose of this study was to compare the clinical and radiological outcomes and failure rates between nonoperative treatment and revision ACL reconstruction for traumatic partial ACL graft rupture. We hypothesized that the outcomes and failure rates would be comparable and that nonoperative treatment of traumatic partial ACL graft rupture can produce satisfactory outcomes.
Cohort study; Level of evidence, 3.
We retrospectively evaluated 2114 patients treated for isolated ACL rupture between January 2000 and June 2020. Patients with traumatic partial graft rupture after ACL reconstruction with minimum 2-year follow-up data were included. Patients who met all the following conditions were candidates for nonoperative treatment: (1) Lachman or pivot-shift grade 0 or 1 at 6 months after ACL reconstruction, (2) ACL graft with low to intermediate signal intensity on 1-year postoperative magnetic resonance imaging (MRI), and (3) MRI after reinjury showing definite evidence of trauma, some fibers remaining in continuity of the ACL graft, and no anterior tibial subluxation in the sagittal plane. The patients were divided into 2 groups according to treatment method: nonoperative treatment (group A) and revision ACL reconstruction (group B). Clinical scores, laxity test results, radiological outcomes, and graft failures were compared between the groups.
In total, 47 patients had traumatic partial graft rupture (group A, n = 10; group B, n = 37). There were no significant differences between the 2 groups in terms of clinical scores, laxity tests, radiological outcomes, or graft failure.
The clinical and radiological outcomes of nonoperative treatment of traumatic partial graft rupture after ACL reconstruction were comparable with those of revision ACL reconstruction. Nonoperative treatment of traumatic partial ACL graft rupture can produce satisfactory outcomes in selected patients.
目前尚无关于创伤性部分前交叉韧带（ACL）移植物断裂非手术治疗的研究。
目的/假设：本研究的目的是比较创伤性部分ACL移植物断裂的非手术治疗与ACL翻修重建的临床和影像学结果及失败率。我们假设结果和失败率将具有可比性，并且创伤性部分ACL移植物断裂的非手术治疗可以产生令人满意的结果。
队列研究；证据等级，3级。
我们回顾性评估了2000年1月至2020年6月期间接受单纯ACL断裂治疗的2114例患者。纳入ACL重建术后发生创伤性部分移植物断裂且有至少2年随访数据的患者。符合以下所有条件的患者为非手术治疗候选者：（1）ACL重建术后6个月时Lachman试验或轴移试验为0级或1级，（2）术后1年磁共振成像（MRI）显示ACL移植物信号强度低至中等，（3）再次受伤后的MRI显示有明确的创伤证据，ACL移植物仍有一些纤维连续，矢状面无胫骨前移。根据治疗方法将患者分为2组：非手术治疗组（A组）和ACL翻修重建组（B组）。比较两组的临床评分、松弛试验结果、影像学结果和移植物失败情况。
共有47例患者发生创伤性部分移植物断裂（A组，n = 10；B组，n = 37）。两组在临床评分、松弛试验、影像学结果或移植物失败方面无显著差异。
ACL重建术后创伤性部分移植物断裂的非手术治疗的临床和影像学结果与ACL翻修重建相当。创伤性部分ACL移植物断裂的非手术治疗在选定患者中可产生满意的结果。
