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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Multiligament Knee Injuries in Older Adolescents: A 2-Year Minimum Follow-up Study
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Multiligament Knee Injuries in Older Adolescents: A 2-Year Minimum Follow-up Study

机译：老年多发性膝关节损伤：两年最低随访研究

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Background: Multiligament knee injuries cause significant functional impairment. Adults undergoing anatomic reconstruction of multiligament knee injuries have excellent outcomes postoperatively. However, less is known about the outcomes in adolescent patients following multiligament reconstruction. Purpose/Hypothesis: We aimed to assess patient outcomes and failure rates following unstaged multiligament reconstruction in an adolescent population at a minimum 2-year follow-up. We hypothesized that outcomes of multiligament reconstruction in these patients would be comparable to previously reported outcomes in the adult population. Study Design: Case series; Level of evidence, 4. Methods: The study included patients who had undergone multiligament knee reconstruction at 19 years of age or younger and had at least 2 years of follow-up. All procedures were performed by the same surgeon. Exclusion criteria included patient age 14 years or younger at the time of surgery, open physes, prior ipsilateral meniscal or knee ligament surgery, or a tibial plateau fracture at the time of injury. Multiligament reconstruction was defined as a reconstruction of at least 1 cruciate ligament and at least 1 component of the posterolateral corner or the medial knee. Patients were evaluated according to Lysholm score, Tegner score, Short Form–12 physical component summary (SF-12 PCS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and postoperative patient satisfaction. Results: Twenty patients (mean age, 17.7 years; mean follow-up, 37.1 months) were included in this study. No patient required additional ligament surgery after the index surgery because of graft failure. The median preoperative Lysholm score was 49.5 (range, 18-90), and the median postoperative Lysholm score was 86 (range, 44-100) ( P < .001). The median preoperative Tegner activity score was 2 (range, 0-9), and the median postoperative Tegner activity score was 6 (range, 2-10) ( P = .012). The median SF-12 PCS improved from 40.5 preoperatively to a median of 56.1 postoperatively ( P < .001). WOMAC total score improved from a median of 26.5 preoperatively to a median of 2 postoperatively ( P < .001). Median postoperative patient satisfaction was 10 (range, 5-10). Conclusion: Single-stage multiligament knee reconstruction is a reliable procedure that improves knee function at 2-year follow-up in adolescent patients. Patient satisfaction was excellent, but longer follow-up in a larger series of patients is required to determine the long-term benefits of multiligament reconstruction in this patient population.
机译：背景：多韧带膝关节损伤会导致严重的功能障碍。接受多韧带膝关节解剖重建的成年人术后效果良好。然而，关于多韧带重建后青少年患者的预后知之甚少。目的/假设：我们的目标是在至少两年的随访中评估青少年人群中无阶段多配体重建后的患者结果和失败率。我们假设在这些患者中多配体重建的结果与成人人群中先前报道的结果相当。研究设计：案例系列;证据级别，第4级。方法：该研究包括19岁或以下接受多韧带膝关节重建术并至少随访2年的患者。所有程序均由同一位外科医生执行。排除标准包括手术时年龄不超过14岁，开放性植骨，同侧半月板或膝关节韧带手术之前的患者，或受伤时胫骨平台骨折。多韧带重建术的定义是重建至少1个交叉韧带和至少1个后外侧角或内侧膝盖的组件。根据Lysholm评分，Tegner评分，简短表格-12身体成分摘要（SF-12 PCS），西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）评分以及术后患者满意度对患者进行评估。结果：20例患者（平均年龄17.7岁;平均随访37.1个月）纳入本研究。由于移植失败，没有患者需要在索引手术后进行额外的韧带手术。术前Lysholm评分中位数为49.5（范围18-90），术中Lysholm评分中位数为86（范围44-100）（P <.001）。术前Tegner活动评分中位数为2（范围0-9），术后Tegner活动评分中位数为6（范围2-10）（P = 0.012）。 SF-12 PCS的中位数从术前的40.5改善到术后的56.1（P <.001）。 WOMAC总分从术前的26.5改善到术后的2（P <0.001）。术后患者满意度中位数为10（范围5-10）。结论：单阶段多韧带膝关节重建术是一种可靠的方法，可改善青少年患者2年随访时的膝盖功能。患者满意度非常好，但是需要更多的患者进行长期随访才能确定该患者群体中多配体重建的长期利益。

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