Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Am J Sports Med. 2024 Dec;52(14):3595-3601. doi: 10.1177/03635465241293726. Epub 2024 Nov 14.
Previous studies have examined the relationship between patient resilience and functional outcome scores after anterior cruciate ligament reconstruction (ACLR). However, past studies have failed to explore the longitudinal relationship between preoperative resilience and functional outcomes 2 years after ACLR.
To evaluate the relationship between preoperative patient resilience and functional outcomes 2 years after ACLR.
Cohort study; Level of evidence, 3.
Patients were identified who underwent ACLR for anterior cruciate ligament tears between January and June 2020 at a single institution. Those who completed the Brief Resilience Scale preoperatively as part of routine patient questionnaires were considered for inclusion. Patients were contacted a minimum of 2 years after ACLR to complete the short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-JR), Single Assessment Numeric Evaluation (SANE), International Knee Documentation Committee (IKDC) Subjective Knee Form, and visual analog scale (VAS). Outcomes were compared among patients with low resilience (LR), normal resilience (NR), and high resilience (HR), as defined in a previous study..
A total of 81 patients were included in the final analysis, with 14 patients in the low preoperative resilience group, 54 in normal, and 13 in high. The mean age of the cohort was 32.0 years, and there were no significant differences in age, sex, race, graft type, or psychiatric comorbidities among the resilience groups. Significantly increased postoperative KOOS-JR scores were observed in patients in the HR group as compared with those in the NR and LR groups (94.8, 86.7, and 79.6, respectively; = .031). There were also significantly increased postoperative SANE scores in patients in the HR group versus those in the NR and LR groups (92.3, 83.5, and 69.2; = .012). Patients with high preoperative resilience achieved the IKDC Patient Acceptable Symptom State at significantly higher rates ( = .003). No significant differences were observed in postoperative VAS ( = .364), IKDC ( = .072), or change in IKDC ( = .448) over time among resilience groups. Postoperatively, 30 patients (37.0%) changed resilience groups, with 13 moving down and 17 moving up in category (low, n = 12; normal, n = 55; high, n = 14).
Preoperative resilience correlated with KOOS-JR and SANE scores 2 years after ACLR but did not correlate with VAS, IKDC, or change in IKDC over the same period. Resilience was not static, with changes in resilience observed from initial to final evaluations. Resilience is not a strong predictor of postoperative patient-reported outcomes after ACLR.
先前的研究已经探讨了患者韧性与前交叉韧带重建（ACLR）后功能结果之间的关系。然而，过去的研究未能探索术前韧性与 ACLR 后 2 年的功能结果之间的纵向关系。
评估术前患者韧性与 ACLR 后 2 年功能结果之间的关系。
队列研究；证据水平，3 级。
在一家单机构中，确定了 2020 年 1 月至 6 月期间因前交叉韧带撕裂而接受 ACLR 的患者。那些作为常规患者问卷调查的一部分，在术前完成了简短韧性量表的患者被认为符合纳入标准。在 ACLR 后至少 2 年，联系患者以完成膝关节损伤和骨关节炎结果评分（KOOS-JR）短表、单一评估数字评估（SANE）、国际膝关节文献委员会（IKDC）主观膝关节表和视觉模拟量表（VAS）。根据先前研究中的定义，将韧性低（LR）、正常（NR）和高（HR）的患者进行比较。
共有 81 名患者纳入最终分析，术前低韧性组 14 名，正常组 54 名，高韧性组 13 名。队列的平均年龄为 32.0 岁，在韧性组之间，年龄、性别、种族、移植物类型或合并精神疾病无显著差异。与 NR 和 LR 组相比，HR 组患者的术后 KOOS-JR 评分显著增加（分别为 94.8、86.7 和 79.6； =.031）。与 NR 和 LR 组相比，HR 组患者的术后 SANE 评分也显著增加（分别为 92.3、83.5 和 69.2； =.012）。术前高韧性患者达到 IKDC 患者可接受症状状态的比例显著更高（ =.003）。在韧性组之间，术后 VAS（ =.364）、IKDC（ =.072）或 IKDC 变化（ =.448）随时间无显著差异。术后，30 名患者（37.0%）改变了韧性组，13 名患者降级，17 名患者升级（低，n = 12；正常，n = 55；高，n = 14）。
术前韧性与 ACLR 后 2 年的 KOOS-JR 和 SANE 评分相关，但与同一时期的 VAS、IKDC 或 IKDC 变化不相关。韧性不是静态的，从初始评估到最终评估都观察到韧性的变化。韧性不是 ACLR 后患者报告结果的有力预测指标。
