Georgetown University School of Medicine, Washington, DC, 20007, US.
Department of Orthopedic Surgery, MedStar Georgetown University Hospital, Washington, DC, 20007, US.
Eur J Orthop Surg Traumatol. 2024 Nov 15;35(1):4. doi: 10.1007/s00590-024-04133-z.
This study evaluated patient-reported outcome measures and reinjury rates in higher-risk adolescents and young adults aged 14-25 years old following Anterior Cruciate Ligament reconstruction using autograft with suture tape augmentation (SA ACLR).
We performed a retrospective case series of patients aged 14-25 who underwent SA ACLR by a single surgeon between 2016 and 2020. After a minimum of 2 years of follow-up, data was collected on reinjury and patient reported outcome measures, including Knee Injury and Osteoarthritis Outcome Score (KOOS), Marx Activity Rating Scale (MARS), Single Assessment Numeric Evaluation (SANE), and Visual Analog Pain Scale (VAPS).
27 patients were identified. 4 were lost to follow-up, and 23 met inclusion criteria (11 male, 12 female). Average age was 20, and average follow-up was 2.5 years. Failure rate was 8.7%, with two patients requiring revision ACL reconstruction. One patient required two additional meniscal operations with intraoperative findings demonstrating maintenance of an intact ACL. Postoperative patient-reported outcomes measures (PROMs) were obtained for the patients who did not require additional surgery (n = 20), and preoperative PROMs were available for 16 of these patients. Postoperatively, patients reported a mean VAPS of 0.74 ± 1.27, MARS of 8.05 ± 5.58, and SANE of 83.05 ± 16.47. Mean KOOS was 86.92 ± 11.77 with subscores Pain of 86.94 ± 12.94, Symptoms of 82.16 ± 14.96, ADL of 95.81 ± 8.10, Sport of 75.61 ± 21.52, and QOL of 70.64 ± 22.04. Paired t-tests demonstrated significant improvements in VAPS, SANE, and KOOS outcomes following surgery. Patients were significantly less active postoperatively as reported by the MARS. A multivariable regression analysis showed that increased age predicted poorer postoperative KOOS Pain outcomes, and female sex predicted inferior KOOS Pain and Sport outcomes.
SA ACLR is a safe and effective surgical technique in the high failure risk young adult demographic, with a low reinjury rate and acceptable KOOS scores. Patients were active with minimal pain at minimum two years of follow-up. Female sex was a risk factor for poorer outcomes in this population.
本研究评估了使用带缝线带增强的移植物（SA ACLR）对 14-25 岁高风险青少年和年轻成年人进行前交叉韧带重建后的患者报告的结果测量和再损伤率。
我们对 2016 年至 2020 年间由同一位外科医生进行的 SA ACLR 的 14-25 岁患者进行了回顾性病例系列研究。至少随访 2 年后，收集了再损伤和患者报告的结果测量数据，包括膝关节损伤和骨关节炎结果评分（KOOS）、马克思活动评分量表（MARS）、单项评估数字评估（SANE）和视觉模拟疼痛量表（VAPS）。
确定了 27 名患者。4 名患者失访，23 名符合纳入标准（男性 11 名，女性 12 名）。平均年龄为 20 岁，平均随访时间为 2.5 年。失败率为 8.7%，两名患者需要进行 ACL 重建翻修。一名患者需要进行两次额外的半月板手术，术中发现 ACL 保持完整。对未进行额外手术的患者（n=20）获得了术后患者报告的结果测量值（PROMs），其中 16 名患者可获得术前 PROMs。术后，患者报告 VAPS 平均为 0.74±1.27，MARS 为 8.05±5.58，SANE 为 83.05±16.47。平均 KOOS 为 86.92±11.77，子评分疼痛为 86.94±12.94，症状为 82.16±14.96，ADL 为 95.81±8.10，运动为 75.61±21.52，生活质量为 70.64±22.04。配对 t 检验表明术后 VAPS、SANE 和 KOOS 结果显著改善。MARS 报告患者术后活动明显减少。多变量回归分析显示，年龄增加预测术后 KOOS 疼痛结局较差，女性预测 KOOS 疼痛和运动结局较差。
SA ACLR 是一种安全有效的手术技术，适用于高失败风险的年轻成年人群，再损伤率低，KOOS 评分可接受。患者在至少 2 年的随访中保持活跃，疼痛最小。在该人群中，女性是较差结局的危险因素。
