Mann Oliver, Al-Dadah Oday
The Medical School, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom.
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom.
World J Orthop. 2024 Aug 18;15(8):744-753. doi: 10.5312/wjo.v15.i8.744.
Patient reported outcome measures (PROMs) can be used to assess knee function following anterior cruciate ligament (ACL) reconstruction. Intra-operatively, femoral and tibial tunnels are created to accommodate the new ACL graft. It is postulated that there is an optimum position and orientation of these tunnels and that outcomes from this procedure are affected by their position.
To evaluate the influence of graft tunnel position on early to mid-term clinical outcomes following ACL reconstruction.
Six PROMs were collected following ACL reconstruction which included the Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee, Lysholm, Tegner, EuroQol-5 Dimension-5 level, and Short Form 12-item Health Survey. A total of 8 radiological parameters were measured from post-operative X-rays relating to graft tunnel positions. This data was analysed to assess for any correlations between graft tunnel position and post-operative PROMs.
A total of 87 patients were included in the study with a mean post-operative follow-up of 2.3 years (range 1 to 7 years). Posterior position of tibial tunnel was associated with improved KOOS quality of life (rho = 0.43, = 0.002) and EQ-5D VAS (rho = 0.36, = 0.010). Anterior position of EndoButton femoral tunnel was associated with an improved EQ-5D index (rho = -0.38, = 0.028). There were no other significant correlations between any of the other radiological parameters and PROM scores.
Overall, graft tunnel position had very little correlation with clinical outcomes following ACL reconstruction. A few (posterior) tibial tunnel and (anterior) EndoButton femoral tunnel measurements were associated with better PROMs.
患者报告结局测量（PROMs）可用于评估前交叉韧带（ACL）重建后的膝关节功能。手术中，需创建股骨和胫骨隧道以容纳新的ACL移植物。据推测，这些隧道存在最佳位置和方向，且该手术的结果会受到其位置的影响。
评估移植物隧道位置对ACL重建后早期至中期临床结局的影响。
在ACL重建后收集了六项PROMs，包括膝关节损伤和骨关节炎结局评分（KOOS）、国际膝关节文献委员会评分、Lysholm评分、Tegner评分、欧洲五维健康量表-5水平和简短健康调查问卷12项。从术后X线片中测量了总共8个与移植物隧道位置相关的放射学参数。对这些数据进行分析，以评估移植物隧道位置与术后PROMs之间的任何相关性。
该研究共纳入87例患者，术后平均随访2.3年（范围1至7年）。胫骨隧道的后方位置与改善的KOOS生活质量相关（rho = 0.43，P = 0.002）和EQ - 5D视觉模拟量表评分相关（rho = 0.36，P = 0.010）。EndoButton股骨隧道的前方位置与改善的EQ - 5D指数相关（rho = -0.38，P = 0.028）。其他放射学参数与PROM评分之间没有其他显著相关性。
总体而言，移植物隧道位置与ACL重建后的临床结局相关性很小。少数（后方）胫骨隧道和（前方）EndoButton股骨隧道测量结果与更好的PROMs相关。
