Aga Cathrine, Trøan Ingrid, Heir Stig, Risberg May Arna, Rana Tariq, Johansen Steinar, Fagerland Morten Wang, Engebretsen Lars
Martina Hansens Hospital, Gjettum, Norway.
Oslo University Hospital, Oslo, Norway.
Knee Surg Sports Traumatol Arthrosc. 2025 Aug;33(8):2781-2792. doi: 10.1002/ksa.12528. Epub 2024 Nov 7.
The purpose of this study was to compare the incidence of knee osteoarthritis (OA) between the anatomic single-bundle (SB) and anatomic double-bundle (DB) anterior cruciate ligament (ACL) reconstruction technique after 5-year follow-up (FU). Secondary objectives were to compare patient-reported outcome measures (PROMs), clinical examination, activity level, functional tests and graft failures between the two groups.
The study was a secondary analysis after 5-year FU of a randomized controlled trial (RCT) (Clinical Trials NCT01033188). One hundred and twenty patients between 18 and 40 years were randomized to either anatomic SB or anatomic DB reconstruction. The Kellgren-Lawrence (KL) classification grade ≥2 and the Osteoarthritis Research Society International (OARSI) atlas criteria score ≥2 were used for defining OA. Additionally, PROMs were obtained and clinical examinations of the knees were performed. Finally, the number of patients experiencing graft failure in each group was recorded.
Radiographic imaging was performed in 39 patients in the SB group and in 37 patients in the DB group. Four patients (10%) in the SB group and two (5%) in the DB group developed osteoarthritis according to the KL classification (p = 0.28). Five (13%) in the SB group and three (8%) in the DB group developed osteoarthritis according to the OARSI atlas criteria (p = 0.59; difference 5.0% [95% confidence interval, CI: -0.10 to 0.20]). There were no significant differences in the PROMs, clinical examinations, activity levels, or functional tests when comparing the two groups. Of initially 62 SB patients, 14 (23%) experienced graft failure compared to 4 (7%) of the 58 DB patients (p = 0.015; difference 0.016 [95% CI: 0.03-0.29]).
At 5-year FU, there were no significant differences in the incidence of OA, PROMS, or other clinical findings comparing the anatomic DB to anatomic SB ACL reconstructed patients. There were fewer graft failures among patients treated with anatomic DB ACL reconstruction.
Level II.
本研究旨在比较解剖单束（SB）和解剖双束（DB）前交叉韧带（ACL）重建技术在5年随访（FU）后膝关节骨关节炎（OA）的发生率。次要目标是比较两组患者报告的结局指标（PROMs）、临床检查、活动水平、功能测试和移植物失败情况。
本研究是一项对随机对照试验（RCT）（临床试验编号NCT01033188）进行5年随访后的二次分析。120名年龄在18至40岁之间的患者被随机分为解剖单束重建组或解剖双束重建组。采用Kellgren-Lawrence（KL）分级≥2级和国际骨关节炎研究学会（OARSI）图谱标准评分≥2分来定义OA。此外，获取PROMs并对膝关节进行临床检查。最后，记录每组中发生移植物失败的患者数量。
SB组39例患者和DB组37例患者进行了影像学检查。根据KL分级，SB组有4例（10%）患者发生骨关节炎，DB组有2例（5%）患者发生骨关节炎（p = 0.28）。根据OARSI图谱标准，SB组有5例（13%）患者发生骨关节炎，DB组有3例（8%）患者发生骨关节炎（p = 0.59；差异5.0% [95%置信区间，CI：-0.10至0.20]）。比较两组时，PROMs、临床检查、活动水平或功能测试方面无显著差异。最初的62例SB患者中有14例（23%）发生移植物失败，而58例DB患者中有4例（7%）发生移植物失败（p = 0.015；差异0.016 [95% CI：0.03 - 0.29]）。
在5年随访时，比较解剖双束与解剖单束ACL重建患者，OA发生率、PROMs或其他临床结果无显著差异。解剖双束ACL重建治疗的患者中移植物失败较少。
二级。
