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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Lateral Tibial Slope is Increased with Patients with Early Graft Failure Following ACL Reconstruction
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Lateral Tibial Slope is Increased with Patients with Early Graft Failure Following ACL Reconstruction

机译：ACL重建后早期移植失败的患者胫骨外侧斜率增加

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Objectives: To determine the relationship between lateral tibial slope and probability of early graft failure in patients who have undergone anterior cruciate ligament (ACL) reconstruction. Methods: Fifty-eight patients were initially identified who experienced graft failure following primary ACL reconstruction and were revised between 1989 and 2009. Exclusion criteria were: clinical follow-up of less than four years, graft failure occurring greater than two years from primary surgery, skeletal immaturity, deep infection, lack of availability of preoperative MRI imaging, and history of previous trauma to the proximal tibia. This left 35 cases of early (within 2 years) failure of primary ACL reconstruction. These cases were matched to 35 controls that had undergone ACL reconstruction with a minimum of 4 years of clinical follow-up and no evidence of graft failure. Patients were matched by age, gender, date of primary surgery, and graft type. Lateral tibial slope was then determined on MRI imaging in blinded fashion. Results: All 35 cases failed within 2 years of primary ACL reconstruction. Mean time to failure in this group was 1 year (range 0.6-1.4 years). Mean follow-up of the matched control group was 6.9 years (range 4.0-13.9 years). Mean lateral tibial slope in the early ACL failure group was found to be 8.4 degrees, which was significantly larger than the control group at 6.5 degrees (p=0.02). The odds ratio for failure considering a 2 degree increase in tibial slope was 1.5 (95% CI 1.02-2.2), and continued to increase to 2.2 (95% CI 1.1-4.6) and 3.3 (95% CI 1.1-10) with 4 degree and 6 degree increases in tibial slope, respectively (Fig 1). No significant association was identified between graft type and primary ACL reconstruction failure. Conclusion: Increased lateral tibial slope is associated with an increased risk for early ACL graft failure, regardless of graft type. Orthopaedic surgeons should consider measuring lateral tibial slope as part of the preoperative assessment of ACL-injured patients.
机译：目的：确定前交叉韧带（ACL）重建患者的胫骨外侧斜率与早期移植失败可能性之间的关系。方法：最初确定了58例在原发性ACL重建后经历移植失败的患者，并于1989年至2009年间进行了修订。排除标准为：临床随访不到4年，移植失败发生于初次手术的2年以上，骨骼不成熟，深部感染，术前MRI成像缺乏可用性以及先前胫骨近端损伤的病史。这留下了35例早期（2年内）原发性ACL重建失败的病例。这些病例与35例接受ACL重建的对照组相匹配，并进行了至少4年的临床随访，并且没有移植失败的迹象。根据年龄，性别，初次手术日期和移植物类型对患者进行匹配。然后在MRI上以盲法在胫骨外侧倾斜。结果：35例均在原发性ACL重建后2年内失败。该组平均失败时间为1年（范围为0.6-1.4年）。配对对照组的平均随访时间为6.9年（4.0-13.9年）。早期ACL衰竭组的平均胫骨外侧倾斜度为8.4度，在6.5度时显着大于对照组（p = 0.02）。考虑到胫骨坡度增加2度，失败的赔率是1.5（95％CI 1.02-2.2），并继续增加到2.2（95％CI 1.1-4.6）和3.3（95％CI 1.1-10），其中4胫骨斜度分别增加5度和6度（图1）。在移植物类型和原发性ACL重建失败之间未发现明显的关联。结论：无论哪种类型，胫骨外侧斜度增加都会增加早期ACL移植失败的风险。骨科医生应考虑测量胫骨外侧倾斜度，作为对ACL受伤患者进行术前评估的一部分。

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