Riccardo Cristiani, Eric Hamrin Senorski, Camilo P Helito, Kristian Samuelsson, Anders Stålman
{"title":"与初次前交叉韧带重建术相比，前交叉韧带翻修重建术（而非双侧前交叉韧带重建术）与临床相关的主观膝关节功能低下有关：对 6831 例患者的对比分析。","authors":"Riccardo Cristiani, Eric Hamrin Senorski, Camilo P Helito, Kristian Samuelsson, Anders Stålman","doi":"10.1002/ksa.12496","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare the subjective knee function in patients undergoing revision and bilateral anterior cruciate ligament (ACL) reconstruction (ACLR) with those undergoing primary ACLR in a large cohort.</p><p><strong>Methods: </strong>Patients without concomitant ligament injuries who underwent primary, revision or bilateral ACLR at the Capio Artro Clinic, Stockholm, Sweden, between 2005 and 2018 were identified. The Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and at 1, 2 and 5 years postoperatively from the Swedish National Knee Ligament Registry. Patients who underwent revision and bilateral ACLR were compared with those who underwent primary ACLR (control group) using Student's t test.</p><p><strong>Results: </strong>A total of 6831 patients (6102 with primary ACLRs, 343 with revision ACLRs and 386 with bilateral ACLRs) were included. Preoperatively, there were significant but nonclinically relevant differences in favour of the revision ACLR group for KOOS Symptoms, Pain, Activities of Daily Living (ADL) and Sport/Rec subscale scores compared with the primary ACLR group. Postoperatively, except for the 1-year Symptoms and ADL subscales, the revision ACLR group reported significantly lower scores on all KOOS subscales than the primary ACLR group, with clinically relevant differences (>8-10 points) for the 1-, 2- and 5-year Sport/Rec and Quality of Life (QOL) subscales. The bilateral ACLR group reported significantly, but not clinically relevant, inferior scores on the 1-year Symptoms and QOL subscales and the 5-year Sport/Rec and QOL subscales compared with the primary ACLR group.</p><p><strong>Conclusions: </strong>Revision ACLR, but not bilateral ACLR, was associated with clinically relevant inferior subjective knee function compared with primary ACLR. It is important to counsel patients regarding their future subjective knee function after repeated ACLR. Compared to primary ACLR, inferior subjective results should be expected after revision ACLR, but not after bilateral ACLR.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Revision ACL reconstruction, but not bilateral ACL reconstruction, is associated with clinically relevant inferior subjective knee function compared with primary ACL reconstruction: A comparative analysis of 6831 patients.\",\"authors\":\"Riccardo Cristiani, Eric Hamrin Senorski, Camilo P Helito, Kristian Samuelsson, Anders Stålman\",\"doi\":\"10.1002/ksa.12496\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate and compare the subjective knee function in patients undergoing revision and bilateral anterior cruciate ligament (ACL) reconstruction (ACLR) with those undergoing primary ACLR in a large cohort.</p><p><strong>Methods: </strong>Patients without concomitant ligament injuries who underwent primary, revision or bilateral ACLR at the Capio Artro Clinic, Stockholm, Sweden, between 2005 and 2018 were identified. The Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and at 1, 2 and 5 years postoperatively from the Swedish National Knee Ligament Registry. Patients who underwent revision and bilateral ACLR were compared with those who underwent primary ACLR (control group) using Student's t test.</p><p><strong>Results: </strong>A total of 6831 patients (6102 with primary ACLRs, 343 with revision ACLRs and 386 with bilateral ACLRs) were included. Preoperatively, there were significant but nonclinically relevant differences in favour of the revision ACLR group for KOOS Symptoms, Pain, Activities of Daily Living (ADL) and Sport/Rec subscale scores compared with the primary ACLR group. Postoperatively, except for the 1-year Symptoms and ADL subscales, the revision ACLR group reported significantly lower scores on all KOOS subscales than the primary ACLR group, with clinically relevant differences (>8-10 points) for the 1-, 2- and 5-year Sport/Rec and Quality of Life (QOL) subscales. The bilateral ACLR group reported significantly, but not clinically relevant, inferior scores on the 1-year Symptoms and QOL subscales and the 5-year Sport/Rec and QOL subscales compared with the primary ACLR group.</p><p><strong>Conclusions: </strong>Revision ACLR, but not bilateral ACLR, was associated with clinically relevant inferior subjective knee function compared with primary ACLR. It is important to counsel patients regarding their future subjective knee function after repeated ACLR. Compared to primary ACLR, inferior subjective results should be expected after revision ACLR, but not after bilateral ACLR.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-10-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12496\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12496","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
引用次数: 0
摘要
目的：在一个大型队列中评估并比较接受翻修和双侧前交叉韧带（ACLR）重建术的患者与接受初次前交叉韧带重建术的患者的主观膝关节功能：方法：对2005年至2018年期间在瑞典斯德哥尔摩Capio Artro诊所接受初次、翻修或双侧前交叉韧带重建术的无并发韧带损伤的患者进行鉴定。从瑞典国家膝关节韧带登记处收集了术前以及术后1年、2年和5年的膝关节损伤和骨关节炎结果评分（KOOS）。采用学生 t 检验比较了接受翻修和双侧前交叉韧带置换术的患者与接受初次前交叉韧带置换术的患者（对照组）：结果：共纳入了 6831 名患者（6102 人接受了初次前交叉韧带置换术，343 人接受了翻修性前交叉韧带置换术，386 人接受了双侧前交叉韧带置换术）。术前，与初次前交叉韧带置换术组相比，修正型前交叉韧带置换术组在 KOOS 症状、疼痛、日常生活活动（ADL）和运动/康复分量表评分方面有显著差异，但无临床相关性。术后，除1年症状和ADL分量表外，修复前交叉韧带组在所有KOOS分量表上的得分均显著低于初治前交叉韧带组，在1年、2年和5年运动/康复和生活质量（QOL）分量表上存在临床相关性差异（>8-10分）。双侧 ACLR 组在 1 年症状和 QOL 分量表以及 5 年运动/康复和 QOL 分量表上的得分明显低于初次 ACLR 组，但与临床无关：结论：与初次前交叉韧带置换术相比，前交叉韧带翻修术（而非双侧前交叉韧带置换术）与临床相关的主观膝关节功能低下有关。在前交叉韧带复通术后，就患者未来的主观膝关节功能进行咨询非常重要。与初次前交叉韧带置换术相比，翻修前交叉韧带置换术后的主观效果要差一些，但双侧前交叉韧带置换术后不会：证据等级：三级。
Revision ACL reconstruction, but not bilateral ACL reconstruction, is associated with clinically relevant inferior subjective knee function compared with primary ACL reconstruction: A comparative analysis of 6831 patients.
Purpose: To evaluate and compare the subjective knee function in patients undergoing revision and bilateral anterior cruciate ligament (ACL) reconstruction (ACLR) with those undergoing primary ACLR in a large cohort.
Methods: Patients without concomitant ligament injuries who underwent primary, revision or bilateral ACLR at the Capio Artro Clinic, Stockholm, Sweden, between 2005 and 2018 were identified. The Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and at 1, 2 and 5 years postoperatively from the Swedish National Knee Ligament Registry. Patients who underwent revision and bilateral ACLR were compared with those who underwent primary ACLR (control group) using Student's t test.
Results: A total of 6831 patients (6102 with primary ACLRs, 343 with revision ACLRs and 386 with bilateral ACLRs) were included. Preoperatively, there were significant but nonclinically relevant differences in favour of the revision ACLR group for KOOS Symptoms, Pain, Activities of Daily Living (ADL) and Sport/Rec subscale scores compared with the primary ACLR group. Postoperatively, except for the 1-year Symptoms and ADL subscales, the revision ACLR group reported significantly lower scores on all KOOS subscales than the primary ACLR group, with clinically relevant differences (>8-10 points) for the 1-, 2- and 5-year Sport/Rec and Quality of Life (QOL) subscales. The bilateral ACLR group reported significantly, but not clinically relevant, inferior scores on the 1-year Symptoms and QOL subscales and the 5-year Sport/Rec and QOL subscales compared with the primary ACLR group.
Conclusions: Revision ACLR, but not bilateral ACLR, was associated with clinically relevant inferior subjective knee function compared with primary ACLR. It is important to counsel patients regarding their future subjective knee function after repeated ACLR. Compared to primary ACLR, inferior subjective results should be expected after revision ACLR, but not after bilateral ACLR.
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