PDF(Pubmed)
Abstract：
UNASSIGNED: There is still debate regarding the association between arthrometric knee laxity measurements and subjective knee outcome and revision surgery after primary anterior cruciate ligament reconstruction (ACLR).
UNASSIGNED: To assess whether arthrometric knee laxity (measured with the KT-1000 arthrometer) 6 months after primary ACLR was associated with the 1-, 2-, and 5-year subjective knee outcomes or revision ACLR at a 5-year follow-up.
UNASSIGNED: Cohort study, Level of evidence 3.
UNASSIGNED: Patients who underwent primary ACLR with a hamstring tendon autograft at the authors\' institution between January 1, 2005, and December 31, 2017, with no concomitant ligamentous injuries, were identified. Anterior knee laxity (KT-1000 arthrometer, 134 N) was assessed 6 months postoperatively. The Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and 1, 2, and 5 years postoperatively. Patients who underwent revision ACLR at any institution in the country within 5 years of primary surgery were identified through the Swedish National Knee Ligament Registry.
UNASSIGNED: A total of 4697 patients (54.3% male) with available KT-1000 arthrometer measurements were included (normal: side-to-side [STS] ≤2 mm, 3015 [64.2%]; nearly normal: STS 3-5 mm, 1446 [30.8%]; abnormal: STS >5 mm, 236 [5.0%]). The only significant difference in subjective knee outcome between the groups was for the KOOS Symptoms subscale at the 1-year follow-up (STS ≤2 mm, 79.9 ± 16.2; STS 3-5 mm, 82.5 ± 14.8; STS >5 mm, 85.1 ± 14.2; P < .001). No other significant differences between the groups were found preoperatively or at 1, 2, or 5 years postoperatively for any of the KOOS subscales. The hazard for revision ACLR within 5 years of the primary surgery was significantly higher for the groups with an STS of 3 to 5 mm (6.6%; 95/1446) (hazard ratio [HR], 1.42; 95% CI, 1.07-1.87; P = .01) and an STS >5 mm (11.4%; 27/236) (HR, 2.61; 95% CI, 1.69-4.03; P < .001) compared with the group with an STS ≤2 mm (3.8%; 116/3015).
UNASSIGNED: A high grade of postoperative knee laxity (STS 3-5 mm and STS >5 mm) 6 months after primary ACLR was associated with an increased hazard of revision ACLR within 5 years, but it was not associated with an inferior subjective knee outcome.
UNASSIGNED: To assess whether arthrometric knee laxity (measured with the KT-1000 arthrometer) 6 months after primary ACLR was associated with the 1-, 2-, and 5-year subjective knee outcomes or revision ACLR at a 5-year follow-up.
UNASSIGNED: Cohort study, Level of evidence 3.
UNASSIGNED: Patients who underwent primary ACLR with a hamstring tendon autograft at the authors\' institution between January 1, 2005, and December 31, 2017, with no concomitant ligamentous injuries, were identified. Anterior knee laxity (KT-1000 arthrometer, 134 N) was assessed 6 months postoperatively. The Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and 1, 2, and 5 years postoperatively. Patients who underwent revision ACLR at any institution in the country within 5 years of primary surgery were identified through the Swedish National Knee Ligament Registry.
UNASSIGNED: A total of 4697 patients (54.3% male) with available KT-1000 arthrometer measurements were included (normal: side-to-side [STS] ≤2 mm, 3015 [64.2%]; nearly normal: STS 3-5 mm, 1446 [30.8%]; abnormal: STS >5 mm, 236 [5.0%]). The only significant difference in subjective knee outcome between the groups was for the KOOS Symptoms subscale at the 1-year follow-up (STS ≤2 mm, 79.9 ± 16.2; STS 3-5 mm, 82.5 ± 14.8; STS >5 mm, 85.1 ± 14.2; P < .001). No other significant differences between the groups were found preoperatively or at 1, 2, or 5 years postoperatively for any of the KOOS subscales. The hazard for revision ACLR within 5 years of the primary surgery was significantly higher for the groups with an STS of 3 to 5 mm (6.6%; 95/1446) (hazard ratio [HR], 1.42; 95% CI, 1.07-1.87; P = .01) and an STS >5 mm (11.4%; 27/236) (HR, 2.61; 95% CI, 1.69-4.03; P < .001) compared with the group with an STS ≤2 mm (3.8%; 116/3015).
UNASSIGNED: A high grade of postoperative knee laxity (STS 3-5 mm and STS >5 mm) 6 months after primary ACLR was associated with an increased hazard of revision ACLR within 5 years, but it was not associated with an inferior subjective knee outcome.
摘要：
■关于初次前交叉韧带重建（ACLR）后关节测量膝关节松弛度与主观膝关节结果和翻修手术之间的关系仍存在争议。
■为了评估原发性ACLR后6个月的关节测量膝关节松弛（用KT-1000关节仪测量）是否与1-相关，2-,和5年主观膝关节结果或5年随访时的修正ACLR。
■队列研究，证据等级3.
在2005年1月1日至2017年12月31日期间在作者机构接受了腿筋肌腱自体移植的原发性ACLR的患者，没有伴随的韧带损伤，已确定。膝关节前松弛度(KT-1000关节仪,134N）在术后6个月进行评估。术前以及术后1、2和5年收集膝关节损伤和骨关节炎结果评分（KOOS）。通过瑞典国家膝关节韧带登记处确定了在初次手术后5年内在该国任何机构接受了ACLR翻修的患者。
■总共包括4697名患者（男性占54.3％），可进行KT-1000关节计测量（正常：左右[STS]≤2mm，3015[64.2%]；接近正常：STS3-5毫米，1446[30.8%];异常:STS>5mm,236[5.0%]）。两组之间主观膝关节结果的唯一显着差异是1年随访时的KOOS症状分量表（STS≤2mm，79.9±16.2;STS3-5mm,82.5±14.8;STS>5mm,85.1±14.2;P<.001)。对于任何KOOS分量表，术前或术后1、2或5年，两组之间均未发现其他显着差异。对于STS为3至5mm（6.6％；95/1446）的组，初次手术后5年内翻修ACLR的风险明显更高（风险比[HR]，1.42；95%CI，1.07-1.87；P=0.01），STS>5mm（11.4%；27/236）（HR，2.61；95%CI，1.69-4.03；P<.001）与STS≤2mm组（3.8%；116/3015）相比。
■原发性ACLR术后6个月膝关节松弛程度高（STS3-5mm和STS>5mm）与5年内修正ACLR的危险增加有关，但它与较低的主观膝关节结果无关。
■为了评估原发性ACLR后6个月的关节测量膝关节松弛（用KT-1000关节仪测量）是否与1-相关，2-,和5年主观膝关节结果或5年随访时的修正ACLR。
■队列研究，证据等级3.
在2005年1月1日至2017年12月31日期间在作者机构接受了腿筋肌腱自体移植的原发性ACLR的患者，没有伴随的韧带损伤，已确定。膝关节前松弛度(KT-1000关节仪,134N）在术后6个月进行评估。术前以及术后1、2和5年收集膝关节损伤和骨关节炎结果评分（KOOS）。通过瑞典国家膝关节韧带登记处确定了在初次手术后5年内在该国任何机构接受了ACLR翻修的患者。
■总共包括4697名患者（男性占54.3％），可进行KT-1000关节计测量（正常：左右[STS]≤2mm，3015[64.2%]；接近正常：STS3-5毫米，1446[30.8%];异常:STS>5mm,236[5.0%]）。两组之间主观膝关节结果的唯一显着差异是1年随访时的KOOS症状分量表（STS≤2mm，79.9±16.2;STS3-5mm,82.5±14.8;STS>5mm,85.1±14.2;P<.001)。对于任何KOOS分量表，术前或术后1、2或5年，两组之间均未发现其他显着差异。对于STS为3至5mm（6.6％；95/1446）的组，初次手术后5年内翻修ACLR的风险明显更高（风险比[HR]，1.42；95%CI，1.07-1.87；P=0.01），STS>5mm（11.4%；27/236）（HR，2.61；95%CI，1.69-4.03；P<.001）与STS≤2mm组（3.8%；116/3015）相比。
■原发性ACLR术后6个月膝关节松弛程度高（STS3-5mm和STS>5mm）与5年内修正ACLR的危险增加有关，但它与较低的主观膝关节结果无关。
