Similar two-year improvement in patient-reported outcomes in patients 40 years and older with outerbridge grade III and IV lesions following ACL reconstruction.

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-09-19 DOI:10.1002/ksa.12470

Rebekah M Kleinsmith, Stephen A Doxey, Haley D Puckett, Fernando A Huyke-Hernández, Arthur J Only, Christopher Y Kweon, Brian P Cunningham

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引用次数: 0

Abstract

Purpose: This study aims to evaluate clinical and patient-reported outcome measures (PROMs) of patients 40 years and older that underwent anterior cruciate ligament reconstruction (ACLR) and determine the influence of preexisting arthritis and chondral wear on ACLR outcomes. We hypothesized that patients aged 40+ with ACLR would have excellent clinical outcomes and PROMs regardless of preexisting arthritic changes.

Methods: A total of 118 patients were included. Patients aged 40 years and older who underwent ACLR in a single healthcare system between 2009 and 2016 were eligible. Outcomes assessed include Knee Injury and Osteoarthritis Outcome Scores (KOOS), Single Assessment Numeric Evaluation (SANE) scores, intraoperative Outerbridge grading, preoperative Kellgren-Lawrence (KL) grading and postoperative complication rates over a 2-year period.

Results: Average increase in KOOS and SANE scores were 21.2 $\pm$ 19.9 and 23.5 $\pm$ 31.3, respectively. Patients with Outerbridge grade III and IV lesions in weight-bearing compartments had lower baseline SANE and KOOS scores than those without (47.1 ± 22.0 vs. 64.5 ± 23.6 baseline SANE and 43.1 ± 18.1 vs. 63.5 ± 15.9 baseline KOOS; p = 0.002 and p < 0.001, respectively) with no significant difference in the amount of change in SANE or KOOS scores (p = 0.111 and p = 0.165 respectively). Patients with KL-grade 2+ osteoarthritis experienced similar changes in KOOS and SANE over the 2-year period to their counterparts (p = 0.598 and p = 0.643, respectively).

Conclusion: There is no correlation between preexisting osteoarthritic changes or chondral defects and PROs. KOOS and SANE scores both increased postoperatively. When treating older patients with an ACL tear, surgeons should consider the activity level and desires of the patient as they determine appropriate treatment. Preexisting osteoarthritis does not correlate with patient-reported outcomes for ACLR.

Level of evidence: Level IV.

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前交叉韧带重建术后，外桥 III 级和 IV 级病变的 40 岁及以上患者的患者报告结果在两年内有类似的改善。

目的：本研究旨在评估 40 岁及以上接受前交叉韧带重建术（ACLR）患者的临床和患者报告结果指标（PROMs），并确定既往关节炎和软骨磨损对 ACLR 结果的影响。我们假设，40 岁以上接受前交叉韧带重建术的患者无论是否存在关节炎变化，都能获得良好的临床疗效和 PROM：共纳入 118 名患者。方法：共纳入 118 名患者，年龄在 40 岁及以上，2009 年至 2016 年期间在单一医疗系统接受前交叉韧带置换术的患者均符合条件。评估结果包括膝关节损伤和骨关节炎结果评分（KOOS）、单次评估数值评价（SANE）评分、术中Outerbridge分级、术前Kellgren-Lawrence（KL）分级以及2年期间的术后并发症发生率：结果：KOOS和SANE评分的平均增幅分别为21.2 ± $\pm $ 19.9和23.5 ± $\pm $ 31.3。在负重区有 Outerbridge III 级和 IV 级病变的患者的基线 SANE 和 KOOS 评分低于无病变的患者（基线 SANE 为 47.1 ± 22.0 vs. 64.5 ± 23.6，基线 KOOS 为 43.1 ± 18.1 vs. 63.5 ± 15.9；P = 0.002 和 P 结论：在负重区有 Outerbridge III 级和 IV 级病变的患者的基线 SANE 和 KOOS 评分低于无病变的患者：已有的骨关节病变或软骨缺损与 PROs 之间没有相关性。术后 KOOS 和 SANE 评分均有所提高。在治疗前交叉韧带撕裂的老年患者时，外科医生在确定适当的治疗方法时应考虑患者的活动水平和愿望。已有的骨关节炎与患者报告的前交叉韧带重建结果无关：证据等级：IV 级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).