Mussell Eric A, Crawford Anna E, Ithurburn Matthew P, Layton Branum O, Fleisig Glenn S, Rothermich Marcus A, Emblom Benton A, Ryan Michael K, Dugas Jeffrey R, Andrews James R, Cain E Lyle
Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.
The American Sports Medicine Institute, Birmingham, Alabama, USA.
Orthop J Sports Med. 2024 Sep 4;12(9):23259671241266619. doi: 10.1177/23259671241266619. eCollection 2024 Sep.
There is a paucity of outcomes data on surgical reconstruction for multiligament knee injury (MLKI) in the orthopaedic literature.
To examine functional and return-to-sports (RTS) outcomes and revision rates after single-stage reconstruction for MLKIs in a cohort containing a large proportion of competitive athletes over a 20-year period.
Case series; Level of evidence, 4.
We identified all patients at our institution who underwent surgical reconstruction for an anterior cruciate ligament (ACL) or bicruciate (ACL-posterior cruciate ligament) MLKI between 2001 and 2020 and had ≥2 years of postoperative outcome data. Patient-reported outcomes were evaluated using the International Knee Documentation Committee (IKDC) form, a surgical satisfaction survey, and questions about subsequent knee surgery and RTS administered via telephone. Summary statistics for all outcomes data were calculated, and predictors of IKDC scores at follow-up were examined using univariable linear regression.
Out of 151 patients eligible for this study, outcomes data were collected in 119 patients (79%). The mean follow-up time was 8.3 ± 4.4 years, and the mean IKDC score at follow-up was 79 ± 17. A total of 83 competitive athletes were included; 62 of these athletes attempted to return to preinjury sport. Among the 62 who attempted RTS, 50 (81%) were successful, and 12 were unable to return due to limitations from their surgery. At follow-up, 112 of the overall cohort of 119 patients (94%) were either satisfied or very satisfied with their surgical outcome, and 91% stated the surgery met or exceeded their expectations. In addition, 24% had subsequent ipsilateral knee operations after their index multiligament knee reconstruction. Older age at surgery and female sex were associated with worse IKDC scores at follow-up.
Despite the severity of the injuries in our cohort, we found high levels of patient-reported function and a high rate of successful RTS in the competitive athletes. Older age and female sex were associated with worse patient-reported knee function at follow-up.
骨科文献中关于多韧带膝关节损伤（MLKI）手术重建的疗效数据较少。
在一个包含很大比例竞技运动员的队列中，研究20年间MLKI单阶段重建后的功能和重返运动（RTS）结果以及翻修率。
病例系列；证据等级，4级。
我们确定了2001年至2020年间在本机构接受前交叉韧带（ACL）或双交叉韧带（ACL-后交叉韧带）MLKI手术重建且有≥2年术后结果数据的所有患者。使用国际膝关节文献委员会（IKDC）表格、手术满意度调查以及通过电话询问的关于后续膝关节手术和RTS的问题来评估患者报告的结果。计算所有结果数据的汇总统计量，并使用单变量线性回归检查随访时IKDC评分的预测因素。
在151名符合本研究条件的患者中，119名患者（79%）收集到了结果数据。平均随访时间为8.3±4.4年，随访时的平均IKDC评分为79±17。共纳入83名竞技运动员；其中62名运动员试图恢复到受伤前的运动水平。在62名尝试RTS的运动员中，50名（81%）成功，12名因手术限制无法恢复。随访时，119名患者总体队列中的112名（94%）对手术结果感到满意或非常满意，91%的患者表示手术达到或超过了他们的期望。此外，24%的患者在初次多韧带膝关节重建后进行了同侧膝关节的后续手术。手术时年龄较大和女性与随访时较差的IKDC评分相关。
尽管我们队列中的损伤严重，但我们发现患者报告的功能水平较高，竞技运动员的RTS成功率较高。年龄较大和女性与随访时患者报告的膝关节功能较差相关。
