METHODS: A total of 30,280 patients with isolated ACLR were identified in the Danish Knee Ligament Reconstruction Registry and divided into four groups; ACLR < 3 months, > 3 months, < 6 months, or > 6 months after injury. Primary outcome was revision surgery and secondary outcome were objective and subjective clinical outcome. The 2 year relative risk, crude, and adjusted hazard ratio (HR) were calculated.
RESULTS: Comparing ACLR < 3 months to ACLR > 3 months of injury the 2 year relative risk of revision surgery was found to be 1.81 (95% CI 1.46-2.23; P < 0.001) with an adjusted hazard ratio (HR) of 1.27 (95% CI 1.12-1.44; P < 0.001). Comparing ACLR < 6 months to ACLR > 6 months of injury the 2 year relative risk of revision surgery was found to be 1.61 (95% CI 1.34-1.92; P < 0.001) with an adjusted HR of 1.27 (95% CI 1.15-1.40; P < 0.001).
CONCLUSIONS: The risk of revision ACLR surgery was found to be increased when ACLR was performed within 3 months or 6 months of injury compared with later surgery. The 1 year postoperative objective knee laxity and the subjective patient-related outcome was found to be without a clinically significant difference; however, those with early ACLR (< 3 months or < 6 months) were found to have a higher activity level 1 year postoperatively. The information about increased risk of revision when having early surgery should be informed to patients when deciding timing of ACLR treatment.
METHODS: II.
方法:在丹麦膝关节韧带重建术中发现了30,280例孤立的ACLR患者,分为四组;ACLR<3个月,>3个月,<6个月,或受伤后>6个月。主要结果是翻修手术,次要结果是客观和主观临床结果。2年相对风险,原油,并计算校正后的风险比(HR)。
结果:比较ACLR<3个月与ACLR>3个月的损伤,发现2年的翻修手术相对风险为1.81(95%CI1.46-2.23;P<0.001),调整后的风险比(HR)为1.27(95%CI1.12-1.44;P<0.001)。比较ACLR<6个月与ACLR>6个月的损伤,2年翻修手术的相对风险为1.61(95%CI1.34-1.92;P<0.001),调整后HR为1.27(95%CI1.15-1.40;P<0.001)。
结论:发现,与损伤后3个月或6个月内进行ACLR相比,修正ACLR手术的风险增加。术后1年客观膝关节松弛度和患者相关的主观结果没有临床显着差异;然而,早期ACLR患者(<3个月或<6个月)术后1年活动水平较高.在决定ACLR治疗时机时,应告知患者早期手术时翻修风险增加的信息。
方法:II.