Wahl Alexander J, Holum Parker, Thompson Xavier D, Sroufe Madison D, Diduch David R, Gwathmey F Winston, Miller Mark D, Hart Joe M
University of Pennsylvania Hospital, Philadelphia, PA, United States.
University of Virginia School of Medicine, Charlottesville, VA, United States.
J Orthop. 2025 May 19;66:213-218. doi: 10.1016/j.jor.2025.05.027. eCollection 2025 Aug.
Current return to sport guidelines following anterior cruciate ligament reconstruction (ACLR) are based on studies focusing on patients with primary and isolated anterior cruciate ligament (ACL) injuries. This study aims to investigate return to sport measures in a population of patients who underwent ACLR with post-operative complications and compare these outcomes to patients who underwent ACLR without complications.
The study screened 788 patients following ACLR and included data from 13 participants who suffered a post-operative complication and matched these participants with those who underwent primary, unilateral ACLR without complication. Complications included cyclops lesion (6), infection (2), fracture (1), wound dehiscence (1), Arthrofibrosis (1), DVT (1) and loose body leading to mechanical symptoms (1). Limb Symmetry Index (LSI) was calculated from strength and hop testing at scheduled post-operative visits. Patient reported outcome measures (PROMs), including the International Knee Documentation Committee (IKDC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS), were collected.
The two groups did not differ in age, height, or mass. There were no significant differences in any strength or hop test variables and the groups reported similar function via PROMs when controlling for graft type and time post-surgery.
There were no differences in LSI and PROMs between patients who underwent ACLR with postoperative complications and patients without complications. This suggests that patients who have complications following ACLR are not necessarily at increased risk for delayed limb strength recovery or worse patient-reported outcomes compared to patients with uncomplicated ACLR at approximately 8.5 months following ACLR.
目前前交叉韧带重建(ACLR)术后恢复运动的指南是基于针对原发性孤立性前交叉韧带(ACL)损伤患者的研究。本研究旨在调查接受ACLR且有术后并发症的患者群体的恢复运动指标,并将这些结果与未发生并发症的ACLR患者进行比较。
该研究筛查了788例ACLR术后患者,纳入了13例有术后并发症的患者的数据,并将这些患者与接受原发性单侧ACLR且无并发症的患者进行匹配。并发症包括独眼病变(6例)、感染(2例)、骨折(1例)、伤口裂开(1例)、关节纤维化(1例)、深静脉血栓形成(1例)和导致机械症状的游离体(1例)。在术后预定随访时通过力量和单腿跳测试计算肢体对称指数(LSI)。收集患者报告的结局指标(PROMs),包括国际膝关节文献委员会(IKDC)和膝关节损伤与骨关节炎结局评分(KOOS)。
两组在年龄、身高或体重方面无差异。在控制移植物类型和术后时间后,任何力量或单腿跳测试变量均无显著差异,且两组通过PROMs报告的功能相似。
接受ACLR且有术后并发症的患者与无并发症的患者在LSI和PROMs方面无差异。这表明,与ACLR后约8.5个月无并发症的ACLR患者相比,ACLR后有并发症的患者不一定有肢体力量恢复延迟或患者报告结局更差的风险增加。