Arthroscopy: The Journal of Arthroscopic & Related Surgery最新文献

英文中文

Suture tape augmentation improves posterior stability after isolated posterior cruciate ligament reconstruction using hamstring tendon autograft with single-bundle transtibial technique 使用腘绳肌腱自体移植物和单束经胫技术进行孤立后交叉韧带重建后，缝合带增量改善了后部稳定性

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Pub Date : 2023-12-22 DOI: 10.1016/j.arthro.2023.12.007

Hangzhou Zhang, Jian Wang, Yuzhong Gao, Peng Zheng, Lianhai Gong

Purpose

The purpose of this study was to assess whether posterior cruciate ligament reconstruction (PCLR) suture tape augmentation can yield more stability after isolated PCLR.

Methods

A prospective database was retrospectively reviewed to identified patients that underwent primary isolated PCLR (control study) or isolated PCLR with suture tape augmentation (study group) from January 2016 to September 2020. the subjective International Knee Documentation Committee Subjective (IKDC) Knee, Lysholm and Tegner scores, posterior draw tests, as well as posterior stress radiographs and return to sports activity rates. The minimal clinically important difference (MCID) was used to evaluate the clinically relevance (subjective IKDC, Lysholm and Tegner scores).

Results

59 were included in this analysis (28 patients in control group, 31 patients in study group). The average length of follow-up was similar between the study and control groups (48.6 vs 47.9months; p=0.800). Knee function, in terms of subjective IKDC (study vs. control: 85.1±6.4 vs. 79.8±6.4; P=0.002), Lysholm (study vs. control: 86.3±7.4 vs. 80.8±7.4; P=0.005) and Tegner (study vs. control: 7.0±1.4 vs. 5.6±1. 7; P=0.006) scores, was significantly improved in the study group. However, the differences between control group and study group were less than the MCID in the subjective IKDC score and Lysholm score. 21.4% (6/28) and 48.4% of patients (15/31) in the control and study groups, respectively, returned to the preinjury sports activity levels (P=0.031). At last follow-up, the mean side-to-side differences in posterior laxity was significantly improved in the study group compared with the control patients (study vs. control: 1.52±0.70 mm vs. 3.17±2.01 mm; p<0.01).

Conclusions

Primary isolated PCLR with suture tape augmentation provides better posterior stability than PCLR without suture tape augmentation at a minimum 2 years follow-up. No differences observed between the groups in the percentage of patients who met or exceeded the MCID in subjective IKDC and Lysholm score.

本研究的目的是评估后交叉韧带重建（PCLR）缝合带增量术是否能在孤立PCLR术后获得更高的稳定性。方法回顾性审查了前瞻性数据库，确定了2016年1月至2020年9月期间接受原发性孤立PCLR术（对照组）或缝合带增量术的孤立PCLR术（研究组）的患者。研究组患者接受了国际膝关节文献委员会主观（IKDC）膝关节、Lysholm 和 Tegner 评分、后方牵引测试、后方应力X光片和运动恢复率。采用最小临床意义差异（MCID）来评估临床相关性（IKDC、Lysholm 和 Tegner 主观评分）。结果59例患者被纳入分析（对照组28例，研究组31例）。研究组和对照组的平均随访时间相似（48.6 个月 vs 47.9 个月；P=0.800）。从主观 IKDC（研究组 vs. 对照组：85.1±6.4 vs. 79.8±6.4；P=0.002）、Lysholm（研究组 vs. 对照组：86.3±7.4 vs. 80.8±7.4；P=0.005）和 Tegner（研究组 vs. 对照组：7.0±1.4 vs. 5.6±1.7；P=0.006）评分来看，研究组的膝关节功能明显改善。然而，在主观 IKDC 评分和 Lysholm 评分方面，对照组和研究组之间的差异小于 MCID。对照组和研究组分别有 21.4% （6/28）和 48.4% （15/31）的患者恢复到了受伤前的运动活动水平（P=0.031）。在最后一次随访中，与对照组患者相比，研究组患者后方松弛的平均侧向差异明显改善（研究组与对照组：1.52±0.70 mm vs. 3.17±2.01 mm；P<0.01）。在主观IKDC和Lysholm评分达到或超过MCID的患者比例方面，观察到两组之间没有差异。

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引用次数: 0

Prior Diagnosis of Opioid Related Disorder is Associated with Higher Medical Resource Utilization Following Primary Hip Arthroscopy: A National Database Study 原发性髋关节镜手术后，阿片类药物相关疾病的诊断与较高的医疗资源利用率有关：一项国家数据库研究

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Pub Date : 2023-12-22 DOI: 10.1016/j.arthro.2023.12.008

Peter F. Monahan, Serkan Surucu, Natalie K. Pahapill, Andrew E. Jimenez, Kenneth F. Taylor

Purpose

To compare adverse events, medical resource utilization, prescribing patterns and revision surgery rates of patients with opioid related disorders (ORD) undergoing primary hip arthroscopy against a propensity matched group with no opioid related disorders (NORD).

Methods

The TriNetX database was queried between January 2015 and December 2020 using ICD-10 and CPT codes to identify patients undergoing primary hip arthroscopy between ages 18 and 70. The ORD cohort was propensity matched in a 1:1 ratio to NORD patients based on age, sex, alcohol related disorders, heart disease, hypertension, metabolic disorders, anxiety disorders, major depressive disorder, diabetes mellitus, and anti-depressant prescriptions. Postoperative rates of adverse events and medical resources were compared within 90 days of procedure, prescriptions were compared within 1 year, and revision surgery were compared within 2 years.

Results

A total of 809 ORD patients were propensity matched in a 1:1 ratio to NORD patients. Postoperative adverse events were similar between groups (P = .693). Rates of revision arthroscopy were also similar for both ORD (9.3%) and NORD (8.0%) cohorts (OR: 1.17 [95% CI 0.83-1.66]; P = .377). ORD patients received care from the emergency department, inpatient admission, outpatient visit, and physical therapy evaluations at higher rates. The ORD cohort received a greater amount of new opioid (OR: 2.66 [95% CI 2.17-3.26]; P < .0001) and antidepressant prescriptions (OR: 1.58 [95%CI 1.26 -1.97]; P < .0001) compared to NORD patients within 1 year of surgery.

Conclusion

ORD patients demonstrated similar rates of adverse events and revision surgery when compared to a propensity matched group of NORD patients undergoing primary hip arthroscopy. However, ORD patients experienced increased rates of ED visits, hospitalizations and were prescribed higher rates of opioid and antidepressant prescriptions.

Level of Evidence

Level III, Cohort Study

目的比较接受初级髋关节镜检查的阿片相关疾病（ORD）患者与无阿片相关疾病（NORD）倾向匹配组的不良事件、医疗资源利用率、处方模式和翻修手术率。方法在 2015 年 1 月至 2020 年 12 月期间，使用 ICD-10 和 CPT 编码查询 TriNetX 数据库，以识别年龄在 18 岁至 70 岁之间接受初级髋关节镜检查的患者。根据年龄、性别、酒精相关疾病、心脏病、高血压、代谢性疾病、焦虑症、重度抑郁症、糖尿病和抗抑郁药处方，按 1:1 的比例将 ORD 队列与 NORD 患者进行倾向匹配。比较了术后90天内的不良事件发生率和医疗资源，比较了1年内的处方，并比较了2年内的翻修手术。两组患者术后不良反应相似（P = .693）。ORD 组（9.3%）和 NORD 组（8.0%）的关节镜翻修率也相似（OR：1.17 [95% CI 0.83-1.66]；P = .377）。ORD患者接受急诊科治疗、住院治疗、门诊治疗和理疗评估的比例较高。与接受初级髋关节镜手术的 NORD 患者相比，ORD 患者在术后 1 年内接受了更多的新阿片类药物处方（OR：2.66 [95%CI 2.17-3.26]；P <；.0001）和抗抑郁药物处方（OR：1.58 [95%CI 1.26-1.97]；P <；.0001）。然而，ORD 患者的急诊室就诊率和住院率均有所上升，阿片类药物和抗抑郁药物的处方率也更高。

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引用次数: 0

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