Department of Orthopaedic Surgery, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan.
Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Ami 300-0394, Ibaraki, Japan.
Medicina (Kaunas). 2024 Jul 29;60(8):1229. doi: 10.3390/medicina60081229.
: Although previous reports have shown that early anterior cruciate ligament (ACL) reconstruction is associated with an increased risk of stiffness, recommendations for delayed surgery are based on outdated literature. The advent of arthroscopic surgery and accelerated rehabilitation protocols warrants a reexamination of the optimal surgical timing. The purpose of this study was to investigate complications during early ACL reconstruction after injury in young athletes. : A total of 87 patients (27 males and 60 females) were included in this study. Patients who underwent anatomic ACL reconstruction using hamstring autografts were evaluated. Patients under 25 years of age with a Tegner activity score greater than 6 were included and classified into three groups according to the time from injury to surgical treatment: one week from injury to surgery (early group), three to six weeks from injury to surgery (normal group), and three to six months from injury to surgery (delayed group). We evaluated the rates of various complications such as graft rupture, contralateral injury, the need for manipulation for loss of ROM, infection, and fracture around the knee up to 2 years postoperatively. In addition, we investigated postoperative muscle strength, Lysholm score, Tegner activity score, and period of the return to sport from injury. Patients in the delayed group were younger than those in the other groups ( = 0.009). Patients in the early group had a lower range of motion than those in the other groups preoperationly. However, the 1-month postoperative range of motion was comparable between groups. Patients in the early group had greater postoperative Tegner activity scores than those in the other groups. The period of return to sport from injury in the delayed group was longer than in the other groups. There were no statistically significant differences in the postoperative complication rate, muscle strength, or Lysholm score. : ACL reconstruction performed 1 week from injury to surgery in young athletic patients indicated the rate of complications were not significantly different among the groups. Early ACL reconstruction with no postoperative complications may be related to early return to sports and a high level of sports.
尽管先前的报告表明，早期前交叉韧带（ACL）重建与僵硬的风险增加有关，但延迟手术的建议是基于过时的文献。关节镜手术和加速康复方案的出现需要重新检查最佳手术时机。本研究旨在探讨年轻运动员受伤后早期 ACL 重建期间的并发症。
共纳入 87 例患者（男 27 例，女 60 例），均接受自体腘绳肌腱解剖 ACL 重建。纳入年龄＜25 岁、Tegner 活动评分＞6 分的患者，并根据受伤至手术治疗的时间分为三组：受伤后 1 周内行手术（早期组）、受伤后 3-6 周内行手术（常规组）、受伤后 3-6 月内行手术（延迟组）。我们评估了术后 2 年内各种并发症的发生率，如移植物破裂、对侧损伤、需要手法复位以恢复关节活动度、感染和膝关节周围骨折。此外，我们还调查了术后肌肉力量、Lysholm 评分、Tegner 活动评分以及从受伤到重返运动的时间。延迟组患者的年龄小于其他组（=0.009）。术前，早期组患者的关节活动度小于其他组。但术后 1 个月，各组间的关节活动度无差异。早期组患者的术后 Tegner 活动评分高于其他组。延迟组从受伤到重返运动的时间较长。术后并发症发生率、肌肉力量和 Lysholm 评分无统计学差异。
在年轻运动患者中，受伤后 1 周内行 ACL 重建的并发症发生率在各组间无显著差异。无术后并发症的早期 ACL 重建可能与早期重返运动和高水平运动有关。
