前交叉韧带重建后 6 至 12 个月持续出现早期膝关节骨关节炎症状。
Persistent Early Knee Osteoarthritis Symptoms From 6 to 12 Months After Anterior Cruciate Ligament Reconstruction.
机构信息
Department of Kinesiology, Michigan State University, East Lansing.
Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester.
出版信息
J Athl Train. 2024 Sep 1;59(9):891-897. doi: 10.4085/1062-6050-0470.23.
CONTEXT
Early identification of knee osteoarthritis (OA) symptoms after anterior cruciate ligament reconstruction (ACLR) could enable timely interventions to improve long-term outcomes. However, little is known about the change in early OA symptoms from 6 to 12 months post-ACLR.
OBJECTIVE
To evaluate the change over time in meeting classification criteria for early knee OA symptoms from 6 to 12 months after ACLR.
DESIGN
Prospective cohort study.
SETTING
Research laboratory.
PATIENTS OR OTHER PARTICIPANTS
Eighty-two participants aged 13 to 35 years who underwent unilateral primary ACLR. On average, participants' first and second visits were 6.2 and 12.1 months post-ACLR.
MAIN OUTCOME MEASURE(S): Early OA symptoms were classified using generic (Luyten Original) and patient population-specific (Luyten Patient Acceptable Symptom State [PASS]) thresholds on Knee injury and Osteoarthritis Outcome Score (KOOS) subscales. Changes in meeting early OA criteria were compared between an initial and follow-up visit at an average of 6 and 12 months post-ACLR, respectively.
RESULTS
Twenty-two percent of participants exhibited persistent early OA symptoms across both visits using both the Luyten Original and PASS criteria. From initial to follow-up visit, 18% to 27% had resolution of early OA symptoms, while 4% to 9% developed incident symptoms. In total, 48% to 51% had no early OA symptoms at either visit. No differences were found for change in early OA status between adults and adolescents.
CONCLUSIONS
Nearly one-quarter of participants exhibited persistent early knee OA symptoms based on KOOS thresholds from 6 to 12 months post-ACLR. Determining if this symptom persistence predicts worse long-term outcomes could inform the need for timely interventions after ACLR. Future researchers should examine if resolving persistent symptoms in this critical window improves later outcomes. Tracking early OA symptoms over time may identify high-risk patients who could benefit from early treatment.
背景
在前交叉韧带重建（ACLR）后早期识别膝关节骨关节炎（OA）症状，可以及时进行干预，改善长期预后。然而，对于 ACLR 后 6 至 12 个月时早期 OA 症状的变化知之甚少。
目的
评估 ACLR 后 6 至 12 个月时，符合早期膝关节 OA 症状分类标准的时间变化。
设计
前瞻性队列研究。
设置
研究实验室。
患者或其他参与者
82 名年龄在 13 至 35 岁之间的患者接受了单侧初次 ACLR。平均而言，患者的首次和第二次就诊时间分别为 ACLR 后 6.2 个月和 12.1 个月。
主要观察指标
使用膝关节损伤和骨关节炎结果评分（KOOS）子量表的通用（Luyten Original）和患者人群特异性（Luyten 患者可接受的症状状态[PASS]）标准对早期 OA 症状进行分类。分别比较 ACLR 后平均 6 个月和 12 个月时的初次就诊和随访时符合早期 OA 标准的变化。
结果
使用 Luyten Original 和 PASS 标准，两次就诊时均有 22%的参与者表现出持续的早期 OA 症状。从初次就诊到随访，18%至 27%的患者 OA 症状得到缓解，而 4%至 9%的患者出现新发症状。共有 48%至 51%的患者在两次就诊时均无早期 OA 症状。成人和青少年之间早期 OA 状态的变化无差异。
结论
在 ACLR 后 6 至 12 个月时，根据 KOOS 阈值，近四分之一的参与者表现出持续的膝关节早期 OA 症状。确定这种症状持续存在是否预示着更差的长期预后，可以为 ACLR 后及时干预提供依据。未来的研究人员应研究在这一关键窗口期内缓解持续症状是否会改善后期结果。随着时间的推移跟踪早期 OA 症状可能会识别出高危患者，他们可能受益于早期治疗。
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