40 岁以上患者的前交叉韧带重建失败率较低:系统回顾

John Roberts IV B.A. , Richard Puzzitiello M.D. , Matthew Salzler M.D.
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引用次数: 0

摘要

目的综述有关≥40 岁患者初次前交叉韧带重建术(ACLR)后并发症和失败率的文献。方法这是对 MEDLINE、CINAHL、SportDiscus、Embase、Web of Science 和 Cochrane 数据库中有关≥40 岁 ACLR 患者临床效果评估研究的二次分析。纳入研究的标准如下:报告年龄≥40 岁患者术后并发症和/或 ACLR 失败率的英语研究。病例报告、技术说明、重复报告患者队列的研究或使用公开登记数据的研究除外。记录了 ACLR 失败定义、失败率、移植物破裂率、ACLR 修复和非 ACLR 修复率以及并发症发生率。89.0%的病例使用了自体移植物。前交叉韧带重建失败的定义各不相同,包括(1)前交叉韧带重建翻修;(2)移植物断裂;(3)临床检查发现膝关节松弛增加;以及(4)术后关节纤维化需要再次手术。在报告这一结果的 9 项研究中,前交叉韧带重建失败率的中位数为 5.0%(范围为 0%-12.1%),其中只有 4 项研究提供了明确的失败定义。前交叉韧带重建翻修手术、移植物断裂和非前交叉韧带重建翻修手术的中位数分别为 0%(范围 0%-7.7%)、2.7%(范围 0%-9.1%)和 7.2%(范围 0%-34.4%)。常见并发症包括疼痛(范围 0%-14.0%)、僵硬(范围 0%-12.7%)、血肿(范围 2.5%-8.8%)、神经血管(范围 0%-41.7%)和未定义(范围 0%-13.8%)。
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Anterior Cruciate Ligament Reconstruction in Patients Over 40 Years Old Shows Low Failure Rates: A Systematic Review

Purpose

To review the literature reporting on complications and failure rates after primary anterior cruciate ligament reconstruction (ACLR) in patients ≥40 years.

Methods

This was a secondary analysis from a prior systematic review of the MEDLINE, CINAHL, SportDiscus, Embase, Web of Science, and Cochrane databases on studies evaluating clinical outcomes in ACLR patients ≥40 years. Studies were included based on the following criteria: English-language studies reporting on postoperative complications and/or ACLR failure rates in patients ≥40 years. Case reports, technical notes, studies with duplicate reporting of patient cohorts, or studies using publicly available registry data were excluded. ACLR failure definitions, failure rates, graft rupture rates, revision ACLR and non-ACLR revision rates, and complication rates were recorded.

Results

Twenty-one studies were included following full-text review. Autografts were used in 89.0% of cases. Definitions for ACLR failure varied, ranging from (1) revision ACLR, (2) graft rupture, (3) clinical examination of increased knee laxity, and (4) postoperative arthrofibrosis requiring an additional surgery. The median ACLR failure rate was 5.0% (range, 0%-12.1%) among the 9 studies reporting this outcome, with only 4 of the studies providing explicit definitions of failure. The median ACLR revision surgery, graft rupture, and non-ACLR revision surgery rates were 0% (range, 0%-7.7%), 2.7% (range, 0%-9.1%), and 7.2% (range 0%-34.4%), respectively. Commonly reported complications included pain (range, 0%-14.0%), stiffness (range, 0%-12.7%), hematoma (range, 2.5%-8.8%), neurovascular (range, 0%-41.7%), and undefined (range, 0%-13.8%).

Conclusions

ACLR in patients over 40 years old shows low failure rates.

Level of Evidence

Level IV, systematic review of Level II-IV studies.

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CiteScore
2.70
自引率
0.00%
发文量
218
审稿时长
45 weeks
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