No difference in ACL revision rates between hamstring and patellar tendon autograft in patients with ACL-R and a concurrent meniscal injury irrespective of meniscal treatment

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-01-23 DOI:10.1002/ksa.12592

Johan Högberg, Lina Petersson, Bálint Zsidai, Alexandra Horvath, Riccardo Cristiani, Kristian Samuelsson, Eric Hamrin Senorski

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Abstract

Purpose

The aims of this study were to compare (1) the rate of anterior cruciate ligament (ACL) revision and (2) subjective knee function using the Knee injury and Osteoarthritis Outcome Score (KOOS) between isolated ACL reconstruction (ACL-R) and ACL-R and concurrent meniscal injury, based on graft selection and meniscal treatment.

Methods

Data from the Swedish National Knee Ligament Registry were extracted in November 2022 for patients who underwent primary ACL-R. Patients were divided into two main groups based on graft choice: hamstring tendon (HT) or patellar tendon (PT) autograft, with four meniscal sub-groups: no injury, resection, repair or left in situ. The primary outcome was the rate of ACL revision within 5 years of primary ACL-R, and the secondary outcome was subjective knee function measured with the mean KOOS subscale scores and the rate of patients achieving a patient-acceptable symptom state (PASS) at the 1-, 2- and 5-year follow-up.

Results

The analysis of ACL revision was performed on 45,656 patients, and 7639 patients for the analysis of subjective knee function. The overall rate of ACL revision was 2.4% and 4.9% at 2 and 5 years, respectively. There were no differences in the rate of ACL revision within 5 years of primary surgery irrespective of graft choice or meniscal injury treatment. Patients with ACL-R and concurrent meniscal resection or meniscal injury left in situ achieved a PASS at the 1 (∆ = −11.3% to −29.5%), 2 (∆ = −12.7% to −40.3%) and 5-year (∆ = −12.0% to −30.6%) follow-up to a greater extent when receiving HT autograft compared to PT autograft.

Conclusion

Graft selection was not associated with ACL revision in patients with ACL-R and concurrent meniscal injury, regardless of meniscal injury treatment. Superior subjective knee function was reported by patients who underwent ACL-R with HT autograft compared with PT autograft where the injured meniscus was resected or left in situ.

Level of Evidence

Level III.

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无论半月板治疗如何，在ACL- r并发半月板损伤患者中，腘绳肌腱和髌骨肌腱自体移植的ACL翻修率无差异。

目的：本研究的目的是比较(1)前交叉韧带（ACL）翻修率和(2)主观膝关节功能，基于移植物选择和半月板治疗，使用膝关节损伤和骨关节炎结局评分（oos）来比较孤立的ACL重建（ACL- r）和ACL- r与并发半月板损伤之间的膝关节功能。方法：从瑞典国家膝关节登记处提取2022年11月接受原发性ACL-R的患者的数据。患者根据移植物的选择分为两组：腘绳肌腱（HT）或髌骨肌腱（PT）自体移植物，以及四个半月板亚组：无损伤、切除、修复或原地保留。主要结局是原发性ACL- r术后5年内ACL的翻修率，次要结局是在1年、2年和5年随访期间，用kos平均亚量表评分和患者达到患者可接受症状状态（PASS）的比例测量主观膝关节功能。结果：对45,656例患者进行了ACL修复分析，对7639例患者进行了主观膝关节功能分析。2年和5年的ACL翻修率分别为2.4%和4.9%。不论移植物选择或半月板损伤治疗，初次手术后5年内ACL翻修率无差异。与PT自体移植物相比，接受HT自体移植物并同时切除半月板或原位半月板损伤的患者在第1期（∆= -11.3%至-29.5%）、第2期（∆= -12.7%至-40.3%）和第5年（∆= -12.0%至-30.6%）随访时获得了更大程度的PASS。结论：在ACL- r合并半月板损伤的患者中，移植物选择与ACL翻修无关，与半月板损伤治疗无关。与切除或保留损伤半月板的PT自体移植物相比，接受ACL-R联合HT自体移植物的患者主观膝关节功能优越。证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).