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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Isolated ACL Reconstruction Versus Combined ACL and Anterolateral Ligament Reconstruction: A Matched Case Series with Mean Follow Up of 9 Years
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Isolated ACL Reconstruction Versus Combined ACL and Anterolateral Ligament Reconstruction: A Matched Case Series with Mean Follow Up of 9 Years

机译：分离的ACL重建与组合ACL和前外韧带重建：一个匹配的案例系列，平均以为9年

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Objectives: The aim of this study was to report long term comparative clinical outcomes of isolated Anterior Cruciate Ligament (ACL) reconstruction versus combined ACL and Anterolateral Ligament (ALL) reconstruction in a matched pair analysis. Methods: A retrospective analysis of prospectively collected data was undertaken. Patients who underwent combined ACL and ALL reconstruction were matched 1:1 to patients who had undergone isolated ACL reconstruction using a propensity score. Matching was based upon age, BMI, side to side laxity difference, duration of time between injury and surgery, type of sports participation (e.g pivoting, contact), presence of concomitant meniscal injuries and their treatment. At the end of the study period all patients completed Lysholm, Tegner, IKDC and KOOS scores, and underwent telephone interview and medical notes review to determine whether they had experienced any complications or re-operations after the index procedure. Kaplan-Meier analysis was used to determine survivorship with respect to graft rupture rates in each group Results: 90 patients who underwent combined ACL and ALL reconstruction were matched to 90 patients who underwent isolated ACL reconstruction. The mean duration of follow up was 108.09±9.43 months (range 97-182). The combined ACLR and ALLR group had significant lower graft rupture rate (3.5%) than the isolated ACLR group (16%) (OR=5.306 ; CI =1.46-19.19 ; p=0.007) (Fig 1). There was no significant difference between groups with respect to non-graft rupture related reoperation rates (secondary meniscectomy, cyclops excision, arthroscopic lavage for infection or hemarthrosis). Contralateral ACL rupture rates were comparable between combined ACL and ALL reconstruction (16.27%) and isolated ACL reconstruction (19.5%) groups. The KOOS score was significantly higher in the combined group with respect to subdomains of pain (p=0.007) and quality of life (p=0.007). There was no significant difference in other KOOS domains, Tegner, Lysholm, or IKDC Conclusions: This study reports the first long-term results of combined ACL and ALL reconstruction. The results demonstrate a significantly lower graft failure rate when compared to isolated ACL reconstruction in a matched pair series with a minimum follow-up of 9 years.
机译：目的：本研究的目的是报告匹配对分析中的分离前十字韧带（ACL）重建的长期比较临床结果与组合ACL和前外韧带（全部）重建。方法：采取了对期收集数据的回顾性分析。接受ACL和所有重建的患者匹配1：1对使用倾向得分经历分离的ACL重建的患者。匹配是基于年龄，BMI，一侧到侧松弛差异，伤害与手术之间的时间持续时间，体育参与类型（例如，枢转，接触），存在伴随的半月板损伤及其治疗。在研究时期结束时，所有患者完成Lysholm，Tegner，IKDC和KOOS分数，接受电话采访和医疗说明审查，以确定他们是否在指数程序后经历过任何并发症或重新运营。 KAPLAN-MEIER分析用于确定每个组结果中的移植性破裂率的生存率：90例接受ACL和所有重建的患者与90名接受分离的ACL重建的患者匹配。后续的平均持续时间为108.09±9.43个月（97-182段）。组合的ACLR和Allr组比分离的ACLR组（16％）（或= 5.306; CI = 1.46-19.19; P = 0.007）（图1）具有显着的较低的接枝破裂率（3.5％）。对于非移植性破裂相关的重组率没有显着的差异（二次末端切除术，Cyclops切除，感染关节性灌洗或腹水的血管灌洗）。组合ACL和所有重建（16.27％）和分离ACL重建（19.5％）组之间的对侧ACL破裂率相当。合并组在疼痛子域（P = 0.007）和寿命质量（P = 0.007）中，KOOS评分显着高。其他KOOS域名，TEGNER，Lysholm或IKDC结论中没有显着差异：本研究报告了ACL组合和所有重建的第一个长期结果。结果表明，与匹配对系列中的分离的ACL重建相比，移植失效率显着降低，其最低随访9年。

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