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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >20 Year Outcomes of ACL Reconstruction with Hamstring Tendon Autograft. Does Age Matter?
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20 Year Outcomes of ACL Reconstruction with Hamstring Tendon Autograft. Does Age Matter?

机译：Ham绳肌腱自体移植重建ACL的20年结果。年龄重要吗？

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Introduction: The purpose of this study was to document the prospective longitudinal outcome of ‘isolated’ anterior cruciate ligament (ACL) ruptures treated with anatomical endoscopic reconstruction using hamstring tendon autograft over 20 years. Long term outcomes were compared between those undergoing ACL reconstruction age 18 or less and those >18 years the time of surgery. Methods: A total of 100 consecutive men and 100 consecutive women with ‘isolated’ ACL rupture underwent four-strand hamstring tendon reconstruction with anteromedial portal femoral tunnel drilling and interference screw fixation by a single surgeon. At the time of ACL reconstruction 39 participants were aged 18 or less, 81 were aged 19 to 25 and 80 were over 25. Reviews were performed pre-operatively and at 1, 2, 7, 15 and 20 years post-operatively. Outcomes included further ACL injury, clinical examination, subjective and objective scoring systems, and radiological assessment. Results: Further ACL injury occurred in 55 of the 200 patients (28%), 37 ruptured the ACL graft and 22 ruptured the contralateral ACL. ACL graft rupture was significantly increased in the young; 39% in those aged 18 or less, 21% of those aged 19-25 and 6% of those over 25 years (p=0.001). Participants with a posterior tibial slope of 12 degrees or more sustained a further ACL injury in 65% of cases. Moderate to severe radiological degenerative change was evident in 14% at 20 years. Outcomes were not statistically different between those aged 18 or less and those >18 years for the variables of IKDC subjective score (p=0.98), rate of return to preinjury activity level (p=0.32), current activity level, or degree of radiological degenerative change at 20 years (p=0.65). Conclusions: ACL reconstructive surgery in patients with an ‘isolated’ rupture using this technique was associated with good long term outcomes and does not appear to cause osteoarthritis, regardless of age. However further ACL injury after ACL reconstruction is significantly more common in the young and those with a high posterior tibial slope. **This study was performed with support from AOA Research Foundation.
机译：简介：这项研究的目的是记录20年来使用绳肌腱自体移植解剖内镜重建治疗“孤立的”前交叉韧带（ACL）破裂的预期纵向结果。在接受18岁或以下ACL重建的患者和手术时间> 18年的患者中，比较了长期结果。方法：总共100例“孤立的” ACL破裂的连续男性和100例连续女性接受四股str绳肌腱重建，由一名外科医生在前门股骨隧道钻孔和干扰螺钉固定中进行。在进行ACL重建时，有39位年龄在18岁以下的参与者，81位19岁至25岁的参与者和80位年龄在25岁以上的参与者。术前和术后1、2、7、15和20岁进行了检查。结果包括进一步的ACL损伤，临床检查，主观和客观评分系统以及放射学评估。结果：200例患者中有55例进一步发生ACL损伤（28％），其中37例破裂了ACL移植物，22例破裂了对侧ACL。年轻的ACL移植物破裂明显增加; 18岁以下的人群中有39％，19-25岁的人群中有21％，25岁以上的人群中有6％（p = 0.001）。胫骨后斜度为12度或更大的参与者在65％的病例中遭受了进一步的ACL损伤。在20年时，有14％的患者出现了中度至严重的放射性退行性改变。对于IKDC主观评分（p = 0.98），损伤前活动水平的恢复率（p = 0.32），当前活动水平或放射学程度等变量，年龄在18岁以下及18岁以上和> 18岁之间的结果无统计学差异。 20年时的退行性变化（p = 0.65）。结论：使用这种技术对“孤立的”破裂患者进行ACL重建手术具有良好的长期效果，并且无论年龄大小，似乎都不会引起骨关节炎。但是，ACL重建后进一步的ACL损伤在年轻人和胫骨后坡高的人群中更为常见。 **这项研究是在AOA研究基金会的支持下进行的。

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