在初级前十字带重建后,关节纤维化再手术的危险因素
Richard Rahardja1, Hamish Love2, Mark G Clatworthy3
1Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
概括
在前十字带 (ACL) 重建后,女性性别,先前的膝盖手术和横钻孔增加了关节纤维化风险. 在受伤后的6个月内推迟手术显示了最低的重新手术率.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学 运动医学
- 生物机械工程 生物机械工程
背景情况:
- 关节纤维化是前十字带 (ACL) 重建后的一个重大并发症,导致硬和疼痛.
- 鉴定因关节纤维化而导致重新手术的风险因素对于改善患者的治疗结果和手术技术至关重要.
研究的目的:
- 为了确定一次性ACL重建后关节纤维化再手术的发病率.
- 确定与需要重新手术的关节纤维化发展相关的患者和手术特异性风险因素.
主要方法:
- 分析了来自新西兰ACL注册表的前性数据,并与事故赔偿公司 (ACC) 的索赔进行了交叉引用.
- 包括2014年4月至2021年5月期间进行的12,296次初级ACL重建的队列.
- 用多变量生存分析来计算针对已识别的风险因素的调整危险比率 (aHR).
主要成果:
- 关节纤维化病的整体再手术率为1.9% (12,296例中有230例),平均随访时间为3.6年.
- 风险增加与女性性别相关 (aHR=1.76),之前的膝盖手术 (aHR=1.82),以及横钻孔技术 (aHR=1.53).
- 在受伤6个多月后进行的ACL重建表明关节纤维化率最低 (1.3%,aHR=0.45).
结论:
- 女性患者,有膝关节手术史的患者和跨孔技术是关节纤维化再手术的重要风险因素.
- 在6周内进行的早期手术与6周至6个月之间的手术相比,并没有增加风险.
- 优化手术时间和技术可能有助于减轻ACL重建后关节纤维化风险.
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