大多数患者报告在四头肌游离肌腱前交叉韧带重建后至少十年的膝关节功能，满意度和临床结果可接受

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-04-01 DOI:10.1016/j.asmr.2024.101062

Cory Hewitt M.D. , Regina Kostyun Ph.D., A.T.C. , John P. Fulkerson M.D. , Matthew E. Shuman M.D. , Clifford G. Rios M.D.

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引用次数: 0

摘要

目的从主观功能、临床结果和膝关节满意度方面描述前交叉韧带重建（ACLR）与无股四头肌自体肌腱移植（QFT）的长期结果。方法对2000 - 2013年QFT-ACLR患者的临床和主观结果进行回顾性分析，并结合前瞻性描述性调查。排除多韧带重建患者。主要结果是临床结果（索引膝关节的再损伤，索引手术后对侧膝关节的ACL损伤），主观功能（国际膝关节文献委员会主观评分，Lysholm评分），膝关节满意度（单一评估数字评估），以及整体健康和福祉（患者报告的结果测量信息系统global -10）。结果术后随访患者34例（平均18.2年，10 ~ 23年），有效率17.3%。手术时平均年龄为32.3±11.1岁，随访时平均年龄为50.4±11.6岁。对于临床结果，23.5%的患者报告了QFT重建前交叉韧带的再损伤。17.6%的患者报告对侧ACL损伤。在手术时，有和没有伴随手术的患者在主观功能和膝关节满意度方面没有差异。在PROMIS全球健康调查中，近三分之二的患者报告了良好的心理健康和身体功能。本研究对QFT-ACLR进行了至少10年的随访，结果显示74%的患者报告没有再损伤，67%的患者报告可接受的特殊主观膝关节功能，74%的患者表示与一般人群相比，他们的身心健康状况更好。在QFT-ALCR时接受伴随软骨手术的患者与没有这些伴随损伤的患者在膝关节功能或满意度评分方面没有观察到差异。证据水平：IV级，治疗性病例系列。

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Most Patients Report Acceptable Knee Function, Satisfaction, and Clinical Outcomes at a Minimum Ten Years After Quadriceps Free Tendon Anterior Cruciate Ligament Reconstruction

Purpose

To describe the long-term outcomes of anterior cruciate ligament reconstruction (ACLR) with quadriceps-free tendon autograft (QFT) in terms of subjective function, clinical outcomes, and knee satisfaction.

Methods

A retrospective chart review design with prospective descriptive survey was used to determine clinical and subjective outcomes for patients treated with a QFT-ACLR from 2000 to 2013. Patients with multiligament reconstructions were excluded. The primary outcomes were clinical outcomes (reinjury of indexed knee, ACL injury to contralateral knee after indexed surgery), subjective function (International Knee Documentation Committee subjective score, Lysholm score), knee satisfaction (single assessment numeric evaluation), and global health and wellbeing (Patient-Reported Outcomes Measurement Information System Global-10).

Results

In total, 34 patients were contacted (average: 18.2 years, range: 10-23 years) after surgery (response rate, 17.3%). The mean age at time of surgery was 32.3 ± 11.1 years, and 50.4 ± 11.6 years at follow-up. For clinical outcomes, 23.5% of patients reported a reinjury of their QFT reconstructed ACL. Contralateral ACL injuries were reported in 17.6% of patients. No differences in subjective function and knee satisfaction were identified between patients with and without concomitant procedure at the time of surgery. Nearly two-thirds of patients reported strong mental health and physical function on the PROMIS Global Health.

Conclusions

This study presents a minimum of 10-year follow-up on QFT-ACLR, revealing 74% of patients reporting no reinjury, 67% of patients reporting acceptable-exceptional subjective knee function, and 74% indicating better physical and mental health compared to the general population. No differences were observed in knee function or satisfaction scores among patients who underwent a concomitant cartilage procedure at the time of QFT-ALCR with patients without these concomitant injuries.