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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Patient Outcomes and Predictors of Success After Revision Anterior Cruciate Ligament Reconstruction
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Patient Outcomes and Predictors of Success After Revision Anterior Cruciate Ligament Reconstruction

机译：修订前交叉韧带重建后的患者疗效和成功预测指标

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Background: Patient outcomes and predictors of success after revision anterior cruciate ligament (ACL) reconstruction are currently limited in the literature. Existing studies either have a small study size or are difficult to interpret because of the multiple surgeons involved in the care of the study sample. Purpose: To determine patient outcomes and predictors of success or failure after a single-stage revision ACL reconstruction by a single fellowship-trained senior surgeon at a single institution. Study Design: Case series; Level of evidence, 4. Methods: A total of 78 patients who underwent revision ACL reconstruction by a single surgeon from 2010 to 2014 were contacted and available for follow-up. The mean time from revision procedure to follow-up was 52 months. Those patients who were able to participate in the study sent in a completed Tegner activity level scale, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and IKDC Current Health Assessment Form. The patients’ medical records were also thoroughly reviewed. Results: Five patients had subsequent failure after revision surgery. The median Tegner score was 6 at follow-up, and the mean subjective IKDC score was 72.5. There was no statistically significant difference in outcome scores when comparing revision graft type, body mass index, sex, need for bone grafting, and time from failure to revision. Patients with failures after primary ACL reconstruction secondary to a traumatic event were found to have statistically significantly higher IKDC scores (mean, 76.6) after revision when compared with nontraumatic failures (mean, 67.1), even when controlling for confounders ( P < .017). Conclusion: Revision ACL reconstruction is effective in improving patient activity levels and satisfaction. However, the subjective IKDC results are quite variable and likely based on multiple factors. Patients with traumatic injuries contributing to graft failure after primary ACL reconstruction had a statistically significantly, although not clinically significant, higher IKDC score after revision surgery compared with nontraumatic failures. These data may be useful when counseling a patient on whether to pursue revision ACL reconstruction surgery.
机译：背景：目前，在修订前十字韧带（ACL）重建后患者的预后和成功的预测因素尚不明确。由于研究样本的护理涉及多个外科医生，因此现有研究规模较小或难以解释。目的：确定由单个受过研究金培训的高级外科医师在单个机构进行的单阶段修订ACL重建后的患者结果以及成功或失败的预测指标。研究设计：案例系列;证据级别：4。方法：从2010年至2014年，总共有78位患者接受了由一名外科医生进行的ACL重建术，并进行了随访。从修订程序到随访的平均时间为52个月。能够参加研究的患者以完整的Tegner活动水平量表，国际膝关节文献委员会（IKDC）主观膝关节评估表和IKDC当前健康评估表发送。还对患者的病历进行了彻底检查。结果：5例患者在翻修手术后出现随后的失败。随访时，Tegner评分中位数为6，而IKDC主观平均评分为72.5。比较翻新植骨类型，体重指数，性别，植骨需求和失败至翻新所需时间时，结局评分在统计学上无显着差异。与非创伤性失败（平均值，67.1）相比，修订后的创伤事件继发原发性ACL重建失败的患者与非创伤性失败（平均值，67.1）相比，在统计学上具有更高的IKDC评分（平均值，76.6）（P <.017） 。结论：修订ACL重建可有效提高患者的活动水平和满意度。但是，主观IKDC结果变化很大，并且可能基于多个因素。进行原发性ACL重建后导致移植失败的创伤性损伤患者，与非创伤性失败相比，翻修手术后的IKDC评分具有统计学上的显着性差异，尽管在临床上并不显着。这些数据在建议患者是否进行翻修ACL重建手术时可能有用。

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