Twelve-year follow-up on anterior cruciate ligament reconstruction - Long-term outcomes of prospectively studied osseous and articular injuries
Twelve-year follow-up on anterior cruciate ligament reconstruction - Long-term outcomes of prospectively studied osseous and articular injuries
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DOI：
10.1177/0363546508315468
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发表时间：
2008-04-01
影响因子：
4.8
通讯作者：
Parker, Richard D.
中科院分区：
文献类型：
--
作者：
Hanypsiak, Bryan T.;Spindler, Kurt P.;Parker, Richard D.
背景资料：虽然在短期内成功恢复膝关节接近正常的松弛度，但前交叉韧带重建并不能阻止创伤后关节炎的发展。假设：最初损伤时（1991年）持续的骨挫伤和关节软骨损伤不会消退。我们的第二个假设是，最初在磁共振成像上发现的骨挫伤或关节软骨损伤的存在与国际膝关节文献委员会问卷评估的前交叉韧带重建术后的长期结局无关。研究设计：队列研究证据等级：1.方法：我们试图联系原始队列的所有患者（N = 54）进行随访评估，包括重复X线片、磁共振成像、体格检查，结果：44例患者（82%的原始队列）返回现场随访。在12年随访时，在原始磁共振成像上没有发现骨挫伤的患者。随访时，最初无骨挫伤的平均（+/- SD）国际膝关节文献委员会评分为70.6（+/- 12.7），观察到骨挫伤时为70.0（+/- 8.1）（P > 0.05）。没有一致的相关性之间的存在初始关节软骨病变与病变的后续磁共振图像。随访时无关节软骨损伤的平均（+/- SD）国际膝关节文献委员会评分为69.0（+/- 11.9）对比72.8结论：在我们的研究中，在最初损伤时通过磁共振成像确定的所有骨挫伤在12年随访时均已消退。国际膝关节文献委员会认为，在前交叉韧带重建术后，初始损伤时骨挫伤的存在并没有显著改变以患者为导向的结局。此外，磁共振成像显示的关节软骨异常不影响国际膝关节文献委员会评分。
Background: Although successful at restoring near normal laxity to the knee in the short term, anterior cruciate ligament reconstructions have not been shown to prevent the development of posttraumatic arthritis.Hypothesis: Bone bruises and articular cartilage injuries sustained at the time of initial injury ( 1991) would not resolve. Our secondary hypothesis was that the presence of a bone bruise or articular cartilage injury originally identified on magnetic resonance imaging would not be associated with long-term outcomes after anterior cruciate ligament reconstruction evaluated by the International Knee Documentation Committee questionnaire.Study Design: Cohort study ( prognosis); Level of evidence, 1.Methods: We attempted to contact all patients from an original cohort (N = 54) for follow-up evaluation, which included repeat radiographs, magnetic resonance images, physical examination, and International Knee Documentation Committee questionnaire more than a decade postoperatively.Results: Forty-four patients (82% of the original cohort) returned for on-site follow-up. No patient with a bone bruise identified on original magnetic resonance imaging had one identified at 12-year follow-up. The mean (+/- SD) International Knee Documentation Committee score at follow-up with no bone bruise originally present was 70.6 ( +/- 12.7) versus 70.0 ( +/- 8.1) when a bone bruise was observed ( P > .05). No consistent association was observed between the presence of an initial articular cartilage lesion with a lesion on follow-up magnetic resonance images. The mean ( +/- SD) International Knee Documentation Committee score at follow-up with no articular cartilage injury was 69.0 ( +/- 11.9) versus 72.8 ( +/- 12.0) with articular cartilage lesion ( P > .05).Conclusion: All bone bruises identified in our study with magnetic resonance imaging at the time of initial injury had resolved at 12-year follow-up. The presence of a bone bruise at the time of initial injury did not significantly alter the patient-oriented outcome by International Knee Documentation Committee after anterior cruciate ligament reconstruction. Additionally, articular cartilage abnormality on magnetic resonance imaging did not influence the International Knee Documentation Committee score.