Cristiani Riccardo, Hansson Frida, Senorski Eric Hamrin, Helito Camilo P, Samuelsson Kristian, Eriksson Karl
Department of Molecular Medicine and Surgery, Section of Sports Medicine, Karolinska Institutet, Stockholm, Sweden.
Stockholm Sports Trauma Research Center (SSTRC), FIFA Medical Centre of Excellence, Stockholm, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2025 Oct;33(10):3457-3465. doi: 10.1002/ksa.12568. Epub 2024 Dec 19.
To evaluate factors associated with revision anterior cruciate ligament reconstruction (ACLR) within 5 years of primary ACLR in children and adolescents.
Children and adolescents (age <20 years at surgery) who underwent primary hamstring tendon ACLR at the Capio Artro Clinic, Stockholm, Sweden, between January 2005 and December 2018 were identified. Revision ACLR within 5 years of primary ACLR was captured in the Swedish National Knee Ligament Registry. Univariable and multivariable logistic regression analyses were used to evaluate the associations between revision ACLR and preoperative (age, sex, body mass index, time from injury to surgery, pre-injury Tegner activity level, medial collateral ligament injury, passive contralateral knee hyperextension [≤-5°]), intraoperative (medial meniscus and lateral meniscus [LM] resection or repair, cartilage injury and graft diameter) and post-operative (KT-1000 side-to-side anterior knee laxity, limb symmetry index for extension and flexion strength and single-leg-hop (SLH) test performance at 6 months) factors at primary ACLR.
A total of 1888 patients (mean age: 16.0 ± 2.0, range: 8-19 years) who underwent primary ACLR were included. The overall incidence of revision ACLR within 5 years was 9.0% (170 out of 1888). Univariable analysis revealed that a time from injury to primary ACLR of <5 months (odds ratio [OR]: 2.27, 95% confidence interval [CI]: 1.61-2.35, p < 0.001) and LM resection (OR: 1.49, 95% CI: 1.00-2.20, p = 0.04) increased the odds of revision ACLR. Multivariable analysis showed that revision ACLR was significantly associated only with a time from injury to primary ACLR of <5 months (OR: 2.56, 95% CI: 1.72-3.70, p < 0.001).
There was a lack of association between revision ACLR and preoperative, intraoperative and post-operative factors at primary ACLR in children and adolescents. A time from injury to primary ACLR of <5 months was the only factor associated with revision ACLR within 5 years.
Level III.
评估儿童和青少年初次前交叉韧带重建术（ACLR）后5年内与翻修相关的因素。
确定2005年1月至2018年12月期间在瑞典斯德哥尔摩卡皮奥关节诊所接受初次绳肌腱ACLR的儿童和青少年（手术时年龄<20岁）。瑞典国家膝关节韧带登记处记录了初次ACLR后5年内的ACLR翻修情况。采用单变量和多变量逻辑回归分析来评估ACLR翻修与初次ACLR时的术前因素（年龄、性别、体重指数、受伤至手术的时间、伤前Tegner活动水平、内侧副韧带损伤、对侧膝关节被动过度伸展[≤-5°]）、术中因素（内侧半月板和外侧半月板[LM]切除或修复、软骨损伤和移植物直径）以及术后因素（KT-1000膝关节前后侧松弛度、屈伸力量的肢体对称指数和6个月时的单腿跳[SLH]测试表现）之间的关联。
共纳入1888例行初次ACLR的患者（平均年龄：16.0±2.0岁，范围：8-19岁）。5年内ACLR翻修的总体发生率为9.0%（1888例中的170例）。单变量分析显示，受伤至初次ACLR的时间<5个月（比值比[OR]：2.27，95%置信区间[CI]：1.61-2.35，p<0.001）和LM切除（OR：1.49，95%CI：1.00-2.20，p=0.04）会增加ACLR翻修的几率。多变量分析表明，ACLR翻修仅与受伤至初次ACLR的时间<5个月显著相关（OR：2.56，95%CI：1.72-3.70，p<0.001）。
儿童和青少年初次ACLR时的术前、术中和术后因素与ACLR翻修之间缺乏关联。受伤至初次ACLR的时间<5个月是与5年内ACLR翻修相关的唯一因素。
三级。
