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Abstract：
OBJECTIVE: Multiple ligament knee injuries (MLKIs) are disruptive injuries, however, there are controversies in the results of acute and delayed reconstruction. Also, clinical outcomes between patients older or younger than 40 have not been compared in MLKIs. This study was designed to investigate the influence of age and timing of reconstruction on the outcomes of single-stage reconstruction of MLKIs.
METHODS: The patients who underwent reconstruction of multiple injured ligaments because of MLKIs between May 2013 and July 2019 were added to the cohort. The postoperative complications, knee range of motion (ROM), Lysholm score, International Knee Documentation Committee (IKDC) 2000 score, Tegner activity level, patient satisfaction, and SF-36 score were compared between young (≤ 40 years old, n = 41) and old patients (n = 61); acute (≤ 3 weeks after injury, n = 75) and delayed reconstruction (n = 27), using Mann-Whitney U test or χ2 test.
RESULTS: A total of 102 MLKI patients managed by single-stage multi-ligament reconstruction were retrospectively reviewed. Patients were followed up after surgery for a mean of 7.3 years (5.2-10.7 years). At the last follow-up, no significant difference was found in knee ROM, functional scores, and patient-reported outcomes between patients older or younger than 40; acute and delayed reconstruction (p > 0.05). The rate of complications in the delayed reconstruction group was higher than that of the acute reconstruction group (22.2% vs 5.3%, p < 0.05). The IKDC objective scores reached grade A in 63.7%-80.4% of patients, and grade B in 11.8%-23.5% patients.
CONCLUSIONS: The single-stage reconstruction of MLKIs can obtain comparative long-term functional and objective outcomes regardless of patients older or younger than 40; acute and delayed reconstruction, however, delayed reconstruction is related to a high rate of postoperative complications.
METHODS: The patients who underwent reconstruction of multiple injured ligaments because of MLKIs between May 2013 and July 2019 were added to the cohort. The postoperative complications, knee range of motion (ROM), Lysholm score, International Knee Documentation Committee (IKDC) 2000 score, Tegner activity level, patient satisfaction, and SF-36 score were compared between young (≤ 40 years old, n = 41) and old patients (n = 61); acute (≤ 3 weeks after injury, n = 75) and delayed reconstruction (n = 27), using Mann-Whitney U test or χ2 test.
RESULTS: A total of 102 MLKI patients managed by single-stage multi-ligament reconstruction were retrospectively reviewed. Patients were followed up after surgery for a mean of 7.3 years (5.2-10.7 years). At the last follow-up, no significant difference was found in knee ROM, functional scores, and patient-reported outcomes between patients older or younger than 40; acute and delayed reconstruction (p > 0.05). The rate of complications in the delayed reconstruction group was higher than that of the acute reconstruction group (22.2% vs 5.3%, p < 0.05). The IKDC objective scores reached grade A in 63.7%-80.4% of patients, and grade B in 11.8%-23.5% patients.
CONCLUSIONS: The single-stage reconstruction of MLKIs can obtain comparative long-term functional and objective outcomes regardless of patients older or younger than 40; acute and delayed reconstruction, however, delayed reconstruction is related to a high rate of postoperative complications.
摘要：
目的：膝关节多发韧带损伤（MLKIs）是破坏性损伤，然而,急性和延迟重建的结果存在争议。此外，在MLKIs中,未对年龄大于40岁或小于40岁的患者的临床结局进行比较.本研究旨在研究年龄和重建时间对MLKIs单阶段重建结果的影响。
方法：在2013年5月至2019年7月期间因MLKIs而接受多发性韧带损伤重建的患者被添加到队列中。术后并发症,膝盖运动范围（ROM），Lysholm得分,国际膝关节文献委员会（IKDC）2000分，Tegner活动级别,患者满意度,和SF-36评分在年轻人(≤40岁，n=41）和老年患者（n=61）；急性（伤后≤3周，n=75)和延迟重建(n=27)，采用Mann-WhitneyU检验或χ2检验。
结果：回顾性分析了102例单阶段多韧带重建术治疗的MLKI患者。术后患者平均随访7.3年（5.2-10.7年）。在最后一次随访中，在膝关节ROM中没有发现显著差异，功能分数，和患者报告的结果在年龄大于或小于40岁的患者之间;急性和延迟重建（p>0.05）。延迟重建组的并发症发生率高于急性重建组(22.2%vs5.3%,p<0.05)。63.7%-80.4%的患者IKDC客观评分达到A级,11.8%-23.5%的患者为B级。
结论：无论年龄大于或小于40岁的患者，单阶段重建MLKIs可获得比较长期的功能和客观结果；急性和延迟重建，然而,重建延迟与术后并发症发生率高有关。
方法：在2013年5月至2019年7月期间因MLKIs而接受多发性韧带损伤重建的患者被添加到队列中。术后并发症,膝盖运动范围（ROM），Lysholm得分,国际膝关节文献委员会（IKDC）2000分，Tegner活动级别,患者满意度,和SF-36评分在年轻人(≤40岁，n=41）和老年患者（n=61）；急性（伤后≤3周，n=75)和延迟重建(n=27)，采用Mann-WhitneyU检验或χ2检验。
结果：回顾性分析了102例单阶段多韧带重建术治疗的MLKI患者。术后患者平均随访7.3年（5.2-10.7年）。在最后一次随访中，在膝关节ROM中没有发现显著差异，功能分数，和患者报告的结果在年龄大于或小于40岁的患者之间;急性和延迟重建（p>0.05）。延迟重建组的并发症发生率高于急性重建组(22.2%vs5.3%,p<0.05)。63.7%-80.4%的患者IKDC客观评分达到A级,11.8%-23.5%的患者为B级。
结论：无论年龄大于或小于40岁的患者，单阶段重建MLKIs可获得比较长期的功能和客观结果；急性和延迟重建，然而,重建延迟与术后并发症发生率高有关。
