Selin Anna S, Gauffin Håkan, Hedevik Henrik, Fältström Anne, Kvist Joanna
Department of Orthopaedics and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Department of Health, Center for Medical Image Science and Visualization (CMIV), Medicine and Caring Sciences, Linköping University, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2025 May;33(5):1709-1720. doi: 10.1002/ksa.12473. Epub 2024 Oct 3.
To describe knee reinjuries and surgeries within 2 years after an acute anterior cruciate ligament (ACL) injury, in patients treated with or without ACL reconstruction (ACLR).
Two years follow-up of 275 patients (52% females, mean age 25.2 [SD 7.0] years) about knee reinjuries and surgeries were analysed from the prospective NACOX cohort study, aiming to describe recovery after an acute ACL injury treated according to clinical routine. Knee reinjury was defined as increase or new symptoms due to new trauma. At 2 years after injury, 169 (61%) had undergone an ACLR. Results are presented with descriptive statistics and risk ratios (RR).
Thirty-two patients sustained reinjuries within 2 years; 6 in the non-ACLR group, and 26 in the ACLR group (7 before and 19 after ACLR). Twelve patients in the ACLR group sustained a graft rupture and three did an ACL revision. Patients with non-ACLR, aged 21-25 years, had a 5.9-fold higher risk for reinjury than those aged 15-20 years (RR 5.9 [1.3-26.9]; p = 0.012). Twenty-four patients had surgery in the non-ACLR group and 36 patients in the ACLR group (excluding primary ACLR), where six were before ACLR and 30 were after ACLR.
Twelve percent sustained a knee reinjury and 21% underwent knee surgery within 2 years after the index ACL injury. There was a higher reinjury incidence in the ACLR group, but no difference in incidence of surgeries. Thus, ACLR did not reduce the risk of traumatic reinjuries or surgeries, which is important for treatment decision considerations.
Level I.
描述急性前交叉韧带（ACL）损伤后2年内，接受或未接受ACL重建术（ACLR）治疗的患者的膝关节再损伤及手术情况。
从前瞻性NACOX队列研究中分析了275例患者（52%为女性，平均年龄25.2[标准差7.0]岁）膝关节再损伤及手术的两年随访情况，旨在描述按照临床常规治疗急性ACL损伤后的恢复情况。膝关节再损伤定义为因新的创伤导致症状加重或出现新症状。受伤2年后，169例（61%）接受了ACLR。结果采用描述性统计和风险比（RR）呈现。
32例患者在2年内发生再损伤；非ACLR组6例，ACLR组26例（ACLR术前7例，术后19例）。ACLR组12例患者发生移植物破裂，3例进行了ACL翻修术。年龄在21 - 25岁的非ACLR患者再损伤风险比15 - 20岁患者高5.9倍（RR 5.9[1.3 - 26.9]；p = 0.012）。非ACLR组24例患者接受了手术，ACLR组36例患者（不包括初次ACLR）接受了手术，其中ACLR术前6例，术后30例。
初次ACL损伤后2年内，12%的患者发生膝关节再损伤，21%的患者接受了膝关节手术。ACLR组再损伤发生率较高，但手术发生率无差异。因此，ACLR并未降低创伤性再损伤或手术的风险，这对治疗决策的考虑很重要。
I级。
