Untreated Injuries to the Anterolateral Capsular Structures Do Not Affect Outcomes and Kinematics after Anatomic Anterior Cruciate Ligament Reconstruction.
Untreated Injuries to the Anterolateral Capsular Structures Do Not Affect Outcomes and Kinematics after Anatomic Anterior Cruciate Ligament Reconstruction.
复制标题
DOI：
10.3390/jcm12134408
复制
发表时间：
2023-06-30
影响因子：
3.9
通讯作者：
Musahl, Volker
中科院分区：
文献类型：
--
作者：
Herbst, Elmar;Costello, Joanna;Popchak, Adam J.;Tashman, Scott;Irrgang, James J.;Fu, Freddie H. H.;Musahl, Volker
背景：前外侧复合体(ALC)的损伤可能导致膝关节旋转松弛增加。然而，在原位治疗时，这种损伤是否会影响体内运动学还没有得到评估。本研究的目的是确定前交叉韧带损伤的分级及其对前交叉韧带损伤患者重建后24个月的运动学和临床结果的影响。假设ALC的损伤将与患者报告的结果(PRO)和下坡跑中的活体膝关节运动学显著相关。方法：35例患者(平均年龄22.8±8.5岁)参加了一项随机临床试验，比较单束和双束重建前交叉韧带。受试者根据ALC损伤的存在或不存在分为两组，根据损伤后6周内进行的MRI扫描确定。没有一名患者接受过这些ALC损伤的治疗。在24个月时，获得专业知识，包括国际膝关节文件委员会主观膝关节形态(IKDC-SKF)、膝关节损伤和骨关节炎结果评分(KOOS)和下坡跑中的活体膝关节运动学。使用皮尔逊卡方检验和曼恩-惠特尼U检验比较ALC损伤组和非ALC损伤组的轴移测试结果、正确率和体内膝关节运动学，P<；0.05有统计学意义。结果：损伤至MRI扫描的平均间隔时间为9.5±10天。在17名(49%)研究参与者中观察到ALC损伤。在有和没有ALC损伤的受试者之间，在PRO和体内运动学方面没有发现显著的差异(N.S.)。结论：这项研究的结果表明，ALC损伤的MRI证据不会对体内膝关节运动学和PRO产生显著影响，即使是在高度ALC损伤的个体中也是如此。MRI上观察到的ALC损伤可能不是前外侧手术的有用指征。
Background: Injuries to the anterolateral complex (ALC) may contribute to increased rotatory knee laxity. However, it has not been evaluated whether such injuries affect in vivo kinematics when treated in situ. The purpose of this study was to determine the grade of ALC injury and its effect on kinematic and clinical outcomes of ACL-injured patients 24 months after anatomic ACL reconstruction. It was hypothesized that injury to the ALC would be significantly related to patient-reported outcomes (PROs) and in vivo knee kinematics during downhill running. Methods: Thirty-five subjects (mean age: 22.8 ± 8.5 years) participating in a randomized clinical trial to compare single- and double-bundle ACL reconstruction were included in the study. Subjects were divided into two groups based on the presence or absence of injury to the ALC, as determined on MRI scans performed within 6 weeks of injury. None of the patients underwent treatment for these ALC injuries. At 24 months, PROs, including the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF), Knee injury and Osteoarthritis Outcome Score (KOOS) and in vivo knee kinematics during downhill running, were obtained. Pivot-shift test results, PROs and in vivo knee kinematics were compared between groups with and without ALC injury using the Pearson’s Chi Squared test and Mann–Whitney U test with significance set at p < 0.05. Results: The average interval between injury and performing the MRI scans was 9.5 ± 10 days. ALC injury was observed in 17 (49%) study participants. No significant differences were detected in PROs and in vivo kinematics between subjects with and without ALC injury (n.s.). Conclusion: The findings of this study demonstrate that MRI evidence of an ALC injury does not significantly affect in vivo knee kinematics and PROs even in individuals with a high-grade ALC injury. Injuries to the ALC as observed on MRI might not be a useful indication for an anterolateral procedure.
登录
查看更多内容
影响因子：
2.2
作者：
Anderst, William;Zauel, Roger;Tashman, Scott
通讯作者：
Tashman, Scott
影响因子：
4.8
作者：
Musahl, Volker;Rahnemai-Azar, Ata A.;Irrgang, James J.
通讯作者：
Irrgang, James J.
影响因子：
4.8
作者：
Guenther, Daniel;Rahnemai-Azar, Amir A.;Debski, Richard E.
通讯作者：
Debski, Richard E.
影响因子：
4.8
作者：
Hussein, Mohsen;van Eck, Carola F.;Fu, Freddie H.
通讯作者：
Fu, Freddie H.
影响因子：
3.8
作者：
Monaco, E.;Ferretti, A.;D'Arrigo, C.
通讯作者：
D'Arrigo, C.