Riccardo Cristiani, Frida Hansson, Eric Hamrin Senorski, Camilo P Helito, Kristian Samuelsson, Karl Eriksson
{"title":"儿童和青少年原发性ACL重建与术前、术中和术后因素缺乏相关性。","authors":"Riccardo Cristiani, Frida Hansson, Eric Hamrin Senorski, Camilo P Helito, Kristian Samuelsson, Karl Eriksson","doi":"10.1002/ksa.12568","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate factors associated with revision anterior cruciate ligament reconstruction (ACLR) within 5 years of primary ACLR in children and adolescents.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lack of association between revision ACL reconstruction and preoperative, intraoperative and post-operative factors at primary ACL reconstruction in children and adolescents.\",\"authors\":\"Riccardo Cristiani, Frida Hansson, Eric Hamrin Senorski, Camilo P Helito, Kristian Samuelsson, Karl Eriksson\",\"doi\":\"10.1002/ksa.12568\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate factors associated with revision anterior cruciate ligament reconstruction (ACLR) within 5 years of primary ACLR in children and adolescents.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-12-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12568\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12568","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Lack of association between revision ACL reconstruction and preoperative, intraoperative and post-operative factors at primary ACL reconstruction in children and adolescents.
Purpose: To evaluate factors associated with revision anterior cruciate ligament reconstruction (ACLR) within 5 years of primary ACLR in children and adolescents.
Methods: 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.
Results: 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).
Conclusion: 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.
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).
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