Results From the Swedish National Anterior Cruciate Ligament Register
Results From the Swedish National Anterior Cruciate Ligament Register
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DOI：
10.1016/j.arthro.2014.02.036
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发表时间：
2014-07-01
影响因子：
4.7
通讯作者：
Forssblad, Magnus
中科院分区：
文献类型：
--
作者：
Kvist, Joanna;Kartus, Juri;Forssblad, Magnus
目的：该研究的目的是分析2005年1月至2012年12月期间登记在瑞典国家前交叉韧带登记册的近24,000名患者的基线变量和临床结果。方法：由2部分组成：1部分是外科医生报告基线和手术资料，1部分是患者在手术前和术后1、2、5年报告膝关节损伤和骨关节炎预后评分(KOOS)和EQ-5D评分。结果：截至2012年12月，已有23,744名患者被登记在外科医生名册上。登记簿上的男女比例为42：58。男、女患者重建前交叉韧带的平均年龄分别为26岁(11岁)和28岁(9岁)。36%的女性患者和49%的男性患者在足球比赛中发生前交叉韧带损伤。2012年，95%的初次前交叉韧带重建是使用自体腿肌腱移植完成的。随访至少5年的患者，翻修率为3.3%，对侧重建率为3.8%。在长达5年的所有随访中，在所有Koos和EQ-5D维度上，接受翻修手术的患者在所有Koos和EQ-5D维度上都比接受初次单侧前交叉韧带重建者的预后差(P<；.001)。在所有随访场合，吸烟者在Koos(P<；.008)和EQ-5D(P<；.024)方面的得分都明显低于不吸烟者。结论：足球是女性和男性患者最常见的损伤原因，接受翻修手术的患者不如接受初次单侧前交叉韧带重建和双侧重建的患者。此外，吸烟者的健康状况不如不吸烟者。在5年期间，前交叉韧带翻修或对侧前交叉韧带重建的累积风险约为7%。对于19岁以下的患者，累积风险明显更高。
Purpose: The purpose of the study was to analyze the baseline variables and clinical outcomes for almost 24,000 patients entered into the Swedish National ACL Register between January 2005 and December 2012. Methods: The register consists of 2 parts: 1 section in which surgeons report baseline and surgical data and 1 section in which patients report the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the EQ-5D score before and 1, 2, and 5 years after surgery. Results: By December 2012, 23,744 patients had been entered into the surgeons' part of the register. The female-male ratio in the register is 42:58. The mean age at primary anterior cruciate ligament (ACL) reconstruction was 26 years (SD, 11 years) and 28 years (SD, 9 years) for the female and male patients, respectively. The ACL injury occurred during soccer in 36% of the female patients and 49% of the male patients. In 2012, 95% of the primary ACL reconstructions were performed using hamstring tendon autografts. For patients who had a minimum of 5 years' follow-up, the revision rate was 3.3% and the contralateral reconstruction rate was 3.8%. On all follow-up occasions up to 5 years, patients who had undergone revision had a significantly (P < .001) poorer outcome than those who had undergone primary unilateral ACL reconstructions in all KOOS and EQ-5D dimensions. On all follow-up occasions, smokers obtained significantly poorer scores than nonsmokers in terms of both the KOOS (P < .008) and the EQ-5D (P < .024). Conclusions: Soccer is the most common cause of injury in both female and male patients, and patients undergoing revisions fare less well than those undergoing primary unilateral ACL reconstructions, as well as bilateral reconstructions. Furthermore, smokers fare less well than nonsmokers. The cumulative risk of an ACL revision or contralateral ACL reconstruction during a 5-year period is approximately 7%. For patients aged younger than 19 years, the cumulative risk is significantly higher.