Husen Martin, Engrav Samantha K, Saul Dominik, Stuart Michael J, Milbrandt Todd A, Levy Bruce A, Krych Aaron J, Saris Daniël B F
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Orthopaedic Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Orthop J Sports Med. 2023 Nov 9;11(11):23259671231209666. doi: 10.1177/23259671231209666. eCollection 2023 Nov.
Little is known about the specific risk of knee injuries due to trampoline accidents in adults compared with children.
To investigate the differences in trampoline-related knee injuries between children and adults and identify risk factors and protective strategies to reduce injury incidence.
Cross-sectional study; Level of evidence, 3.
Data on 229 consecutive patients treated for trampoline-related knee injuries in a single institution were prospectively collected, analyzed, and included. Risk factors, injury patterns, and clinical treatments were compared between skeletally immature and skeletally mature patients. Logistic regression was used to determine the odds ratios for specific risk factors for trampoline-related injuries-including body mass index (BMI), trauma mechanism, patient age, and accident location.
A total of 229 patients met the inclusion criteria; 118 (52%) patients (women, 54.2%; mean age, 8.5 ± 4.1 years) were skeletally immature at the time of injury, and 111 (48%) patients (women, 72%; mean age, 31.9 ± 13.1 years) had closed physes on initial presentation and were classified as skeletally mature. A total of 63 patients (28%) required surgical treatment for their knee injury. Overall, 50 anterior cruciate ligament (ACL) tears, 46 fractures, 39 meniscal tears, 31 ligamentous tears other than ACL, 22 patellar dislocations, and 38 soft tissue injuries, such as lacerations, were recorded. Skeletally mature patients had 7.8 times higher odds (95% CI, 1.6-46.8; < .05) and 19.1 increased odds (95% CI, 5.5-74.9; < .05) of an ACL tear or another ligamentous tear, respectively, compared with skeletally immature patients. Patients who described instability and giving way of the knee as relevant trauma mechanisms had odds of 3.11 (95% CI, 0.9-14.8; < .05) of an ACL tear compared with other trauma mechanisms. Meniscal tears were observed more frequently in the skeletally mature cohort ( < .05). An elevated BMI was associated with a significantly higher relative risk of an ACL tear, a ligamentous tear other than the ACL, and an injury requiring surgery. A third of surgically treated patients were subject to a delayed diagnosis.
Adults had a significantly increased risk of ligamentous and meniscal tears and required operative intervention more often than skeletally immature individuals. Elevated BMI, age, and instability events in terms of trauma mechanism conveyed an increased risk of structural damage to the knee.
与儿童相比，成人因蹦床事故导致膝盖受伤的具体风险知之甚少。
调查儿童和成人蹦床相关膝盖损伤的差异，确定危险因素和保护策略以降低损伤发生率。
横断面研究；证据等级，3级。
前瞻性收集、分析并纳入了在单一机构接受治疗的229例连续蹦床相关膝盖损伤患者的数据。比较骨骼未成熟和骨骼成熟患者的危险因素、损伤模式和临床治疗情况。采用逻辑回归确定蹦床相关损伤的特定危险因素的比值比，包括体重指数（BMI）、创伤机制、患者年龄和事故地点。
共有229例患者符合纳入标准；118例（52%）患者（女性，54.2%；平均年龄，8.5±4.1岁）在受伤时骨骼未成熟，111例（48%）患者（女性，72%；平均年龄，31.9±13.1岁）初次就诊时骨骺已闭合，被归类为骨骼成熟。共有63例患者（28%）因膝盖损伤需要手术治疗。总体而言，记录了50例前交叉韧带（ACL）撕裂、46例骨折、39例半月板撕裂、31例非ACL韧带撕裂、22例髌骨脱位以及38例软组织损伤（如撕裂伤）。与骨骼未成熟患者相比，骨骼成熟患者ACL撕裂或其他韧带撕裂的几率分别高7.8倍（95%CI，1.6 - 46.8；P <.05）和高19.1倍（95%CI，5.5 - 74.9；P <.05）。将膝盖不稳定和打软腿描述为相关创伤机制的患者ACL撕裂的几率为3.11（95%CI，0.9 - 14.8；P <.05），而其他创伤机制的患者ACL撕裂几率较低。在骨骼成熟队列中半月板撕裂更为常见（P <.05）。BMI升高与ACL撕裂、非ACL韧带撕裂以及需要手术治疗的损伤的相对风险显著升高相关。三分之一接受手术治疗的患者被延迟诊断。
与骨骼未成熟个体相比，成人韧带和半月板撕裂的风险显著增加，且更常需要手术干预。就创伤机制而言，BMI升高、年龄以及不稳定事件增加了膝盖结构损伤的风险。
