年龄较大和非运动损伤机制与再次损伤相关,需要在近端腘绳肌腱修复后至少2年的随访中进行翻修手术。

IF 5 2区 医学 Q1 ORTHOPEDICS
Jay R. Ebert, Peter K. Edwards, Elias Ammann, Adam Farrier, Lorcan Gavin, Method Kabelitz, Ross Radic, Antony Liddell, Peter Annear
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引用次数: 0

摘要

目的:探讨近端腘绳肌腱修复后翻修率及与翻修需求相关的因素。方法:本研究纳入243例因急性(176例)或慢性(67例)撕裂而行近端腘绳肌腱修复术的患者。回顾了并发症、再损伤和再手术。采用Cox比例风险回归分析手术2年内再次破裂的危险因素,变量包括年龄、体重指数(BMI)、性别、损伤机制(运动相关或其他)、损伤至手术时间以及合并症包括高血压、高胆固醇血症和2型糖尿病。接受者操作特征分析探讨了与翻修相关的手术时间阈值。结果:总体而言,19例(10.8%)急性队列和11例(16.4%)慢性队列因再撕裂和症状复发接受翻修手术。在急性队列中,再次损伤的风险增加与非运动损伤(相对于运动损伤)相关(风险比[HR] = 3.38;95%置信区间[CI], 1.10-10.39;p = 0.033)和年龄较大(HR = 1.04 /年;95% ci, 1.00-1.08;p = 0.031)。在慢性队列中,年龄、BMI、性别或合并症与翻修手术之间没有显著关联。急性修复的最佳手术阈值为30.5天。结论:在至少2年的随访中,近端腘绳肌修复急性和慢性撕裂的修复率分别为10.8%和16.4%。对于慢性撕裂,没有变量与翻修的需要相关。然而,在急性队列中,年龄较大和非运动损伤与更高的再损伤风险相关。证据级别:四级,回顾性病例系列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Older age and a non-sporting injury mechanism are associated with re-injury and the need for revision surgery over a minimum 2-year follow-up following proximal hamstring tendon repair

Older age and a non-sporting injury mechanism are associated with re-injury and the need for revision surgery over a minimum 2-year follow-up following proximal hamstring tendon repair

Older age and a non-sporting injury mechanism are associated with re-injury and the need for revision surgery over a minimum 2-year follow-up following proximal hamstring tendon repair

Older age and a non-sporting injury mechanism are associated with re-injury and the need for revision surgery over a minimum 2-year follow-up following proximal hamstring tendon repair

Older age and a non-sporting injury mechanism are associated with re-injury and the need for revision surgery over a minimum 2-year follow-up following proximal hamstring tendon repair

Purpose

To investigate revision rates and factors associated with the need for revision following proximal hamstring tendon repair.

Methods

This study included 243 patients who underwent proximal hamstring tendon repair due to an acute (n = 176) or chronic (n = 67) tear. Complications, re-injuries and re-operations were reviewed. Risk factor analysis for re-rupture within 2 years of surgery was conducted using Cox proportional hazards regression, with variables including age, body mass index (BMI), sex, mechanism of injury (sport-related or other), time from injury to surgery and comorbidities including hypertension, hypercholesterolaemia and Type 2 diabetes. Receiver operating characteristic analysis explored time-to-surgery thresholds in relation to revision.

Results

Overall, 19 (10.8%) of the acute cohort and 11 (16.4%) of the chronic cohort underwent revision surgery due to re-tearing and recurrence of symptoms. In the acute cohort, an increased risk of re-injury was associated with a non-sporting (versus sporting) injury (hazard ratio [HR] = 3.38; 95% confidence interval [CI], 1.10–10.39; p = 0.033) and an older age (HR = 1.04 per year; 95% CI, 1.00–1.08; p = 0.031). In the chronic cohort, there were no significant associations between age, BMI, sex or comorbidities, with revision surgery. The optimal threshold for surgery for acute repairs was 30.5 days.

Conclusions

A 10.8% and 16.4% revision rate was observed over a minimum 2-year follow-up following proximal hamstring repair for acute and chronic tears, respectively. For chronic tears, no variables were associated with the need for revision. However, older age and non-sporting injury were associated with a higher risk of re-injury in the acute cohort.

Level of Evidence

Level IV, retrospective case series.

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来源期刊
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).
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