Tanel Luca, Fayard Jean-Marie, Mouton Caroline, Lambrey Pierre-Jean, Letartre Romain, Graveleau Nicolas, Bouguennec Nicolas, Barth Johannes, Thaunat Mathieu
Ramsay Santé, Hôpital privé Jean Mermoz, Centre Orthopédique Santy, FIFA Medical Center of Excellence, Lyon, France.
U.O.C. 1° Clinica Ortopedica, ASST Gaetano Pini-CTO, Milan, Italy.
Knee Surg Sports Traumatol Arthrosc. 2025 May;33(5):1658-1666. doi: 10.1002/ksa.12466. Epub 2024 Sep 20.
This study aimed to evaluate which preoperative patient, injury or clinical factors were associated with the anterior cruciate ligament (ACL) remnant volume in patients undergoing ACL surgery. It was hypothesized that the main factors determining an insufficient ACL remnant volume at the time of surgery were younger age and longer time to surgery.
A retrospective analysis from the Francophone Arthroscopic Society's registry was conducted, including 1565 patients with an ACL lesion underdoing a primary ACL surgery (reconstruction or repair) between June 2020 and June 2023. Patients were excluded in case of revision surgery and incomplete data. Preoperative factors-including patient demographics, delay to surgery, preoperative laxity and the presence of meniscal tears or cartilage lesions-were analysed to determine their influence on ACL remnant volume (estimated by the surgeon as the percentage of residual volume). Univariate, multivariate and receiver operating characteristic curve analyses were performed to explore these relationships.
Multivariate analyses demonstrated that younger age (<20 years and 20-30 years compared to ≥40, p = 0.02), higher time from injury to surgery (≥12 months compared to <3 months, p = 0.01) and the presence of a medial (p = 0.01) or a lateral meniscal tear (p = 0.02) were significant predictors of an ACL remnant volume ≤ 50%.
Younger age (under 30 years of age), a time from injury to surgery above 12 months and the presence of medial and lateral meniscal tears are associated with higher odds of observing a smaller ACL remnant volume at the time of the ACL surgery. These factors should be considered when planning ACL remnant preservation techniques.
Level III.
本研究旨在评估哪些术前患者、损伤或临床因素与接受前交叉韧带（ACL）手术患者的ACL残端体积相关。研究假设，手术时决定ACL残端体积不足的主要因素是年龄较小和手术时间较长。
对法语国家关节镜学会登记处进行回顾性分析，纳入2020年6月至2023年6月期间1565例接受初次ACL手术（重建或修复）的ACL损伤患者。翻修手术和数据不完整的患者被排除。分析术前因素，包括患者人口统计学资料、手术延迟时间、术前松弛度以及半月板撕裂或软骨损伤的存在情况，以确定它们对ACL残端体积（由外科医生估计为残余体积的百分比）的影响。进行单因素、多因素和受试者工作特征曲线分析以探索这些关系。
多因素分析表明，年龄较小（<20岁和20 - 30岁与≥40岁相比，p = 0.02）、受伤至手术时间较长（≥12个月与<3个月相比，p = 0.01）以及存在内侧（p = 0.01）或外侧半月板撕裂（p = 0.02）是ACL残端体积≤50%的显著预测因素。
年龄较小（30岁以下）、受伤至手术时间超过12个月以及存在内侧和外侧半月板撕裂与ACL手术时观察到较小ACL残端体积的较高几率相关。在规划ACL残端保留技术时应考虑这些因素。
三级。
