Goto Kazumi, Honda Eisaburo, Iwaso Hiroshi, Sameshima Shin, Inagawa Miyu, Ishida Yutaro, Matsuo Koji, Kuzuhara Ryota, Sanada Takaki
Department of Sports Orthopaedic Surgery Kanto Rosai Hospital Kawasaki Kanagawa Japan.
J Exp Orthop. 2024 Dec 3;11(4):e70102. doi: 10.1002/jeo2.70102. eCollection 2024 Oct.
Younger age and steep posterior tibial slope (PTS) have been reported as risk factors for graft failure after anterior cruciate ligament reconstruction (ACLR). Few studies have evaluated these risk factors simultaneously in a large cohort of patients undergoing double-bundle ACLR (DB-ACLR). Therefore, this retrospective study aimed to simultaneously investigate known risk factors such as PTS and age in DB-ACLR, determine their thresholds and calculate odds ratios (ORs).
We investigated 482 knees that underwent DB-ACLR with a follow-up period of at least 2 years. Receiver operating characteristic analysis determined cut-off values for age and PTS for graft failure. Subsequently, logistic regression analysis was conducted to evaluate the effects of age, sex, height, weight, laterality, surgical waiting period, pre-operative sport type and level, meniscal injury, hyperextension, general joint laxity and PTS on graft failure.
Graft failure was observed in 33 out of 482 knees (6.8%). Notably, the graft failure group was significantly younger (18.0 ± 5.0 years [standard deviation] vs. 30.4 ± 13.1 years, < 0.01) and had a steeper PTS (11.9 ± 2.3° [standard deviation] vs. 9.6 ± 2.9°, < 0.01) than the group with no graft failure. The cut-off values were 20.0 years for age (specificity, 64.6%; sensitivity, 87.9% and area under the curve, 0.808) and 12.0° for PTS (specificity, 70.9%; sensitivity, 69.7% and area under the curve, 0.734). Logistic regression analysis identified an age of <20 years (OR = 10.1; < 0.01), PTS of ≥12° (OR = 5.6; < 0.01) and pre-operative participation in pivoting sports (OR = 6.0; < 0.01) as significant risk factors for graft failure.
We identified an age of <20 years, PTS of ≥12° and pre-operative participation in pivoting sports as significant risk factors for graft failure after DB-ACLR.
Level III.
据报道，年龄较小和胫骨后倾坡度（PTS）较大是前交叉韧带重建（ACLR）术后移植物失败的危险因素。很少有研究在接受双束ACLR（DB-ACLR）的大量患者队列中同时评估这些危险因素。因此，这项回顾性研究旨在同时调查DB-ACLR中已知的危险因素，如PTS和年龄，确定其阈值并计算比值比（OR）。
我们调查了482例接受DB-ACLR且随访期至少2年的膝关节。通过受试者工作特征分析确定年龄和PTS导致移植物失败的临界值。随后，进行逻辑回归分析，以评估年龄、性别、身高、体重、侧别、手术等待期、术前运动类型和水平、半月板损伤、膝关节过伸、全身关节松弛度和PTS对移植物失败的影响。
482例膝关节中有33例（6.8%）出现移植物失败。值得注意的是，移植物失败组明显更年轻（平均年龄18.0±5.0岁[标准差]，而无移植物失败组为30.4±13.1岁，P<0.01），且PTS更大（平均11.9±2.3°[标准差]，而无移植物失败组为9.6±2.9°，P<0.01）。年龄的临界值为20.0岁（特异性为64.6%；敏感性为87.9%；曲线下面积为0.808），PTS的临界值为12.0°（特异性为70.9%；敏感性为69.7%；曲线下面积为0.734）。逻辑回归分析确定年龄<20岁（OR=10.1；P<0.01）、PTS≥12°（OR=5.6；P<0.01）和术前参与旋转运动（OR=6.0；P<0.01）是移植物失败的重要危险因素。
我们确定年龄<20岁、PTS≥12°和术前参与旋转运动是DB-ACLR术后移植物失败的重要危险因素。
三级。
