改良Lemaire前外侧角重建术不影响高风险患者腘绳肌腱前交叉韧带重建术后2年遗忘关节评分-12
简介
该研究纳入245名16-25岁、术前Tegner≥7的高风险运动员，比较单纯腘绳肌腱自体移植物ACLR与联合改良Lemaire前外侧角重建的2年随访结果。术后12个月单纯ACLR组Forgotten Joint Score-12更高，但未达最小临床重要差异，且24个月时两组评分无差异（70.8 vs 70.9）；联合重建组再断裂率有降低趋势（7.4% vs …
英文摘要
PURPOSE: To compare the Forgotten Joint Score-12 (FJS-12) at 2-year follow-up in patients younger than 25 years, with a preoperative Tegner score ≥7 and intent to return to competitive sports, undergoing either isolated single-bundle hamstring autograft anterior cruciate ligament reconstruction (ACLR) or hamstring autograft ACLR with modified Lemaire anterolateral corner (ALC) reconstruction. METHODS: This single-center retrospective comparative cohort study included patients aged 16 to 25 years with a preoperative Tegner score ≥7 who underwent hamstring autograft ACLR, with or without a modified lateral extra-articular Lemaire tenodesis, between January 2019 and December 2022. Patients completed questionnaires preoperatively and at 6 weeks and 6, 12, and 24 months postoperatively. The primary outcome was FJS-12 at 24 months. Secondary outcomes included other patient-recorded outcome measures and rerupture rates at 24 months. RESULTS: Of 245 included patients, 122 (49.8%) underwent ACLR with a Lemaire ALC reconstruction. The 24-month follow-up rate was 88% (216/245). At 12 months, the FJS-12 was higher in the non-Lemaire group (88.0 ± 15.2 vs 75.0 ± 18.1, P = .003). At 24 months, FJS-12 scores were similar between groups (70.8 ± 21.7 vs 70.9 ± 20.6, P = .96). Within the non-Lemaire group, the FJS-12 declined significantly between 12 and 24 months (79.9 ± 17.9 vs 70.9 ± 20.6, P = .006). No significant differences were found in other patient-recorded outcome measures at 24 months. Reruptures occurred in 18 patients (14.6%) in the non-Lemaire group and 9 (7.4%) in the Lemaire group (P = .11). CONCLUSIONS: At 12 months, isolated ACLR resulted in higher FJS-12 scores compared with ACLR combined with modified Lemaire ALC reconstruction. However, this difference did not exceed the minimal clinically important difference and had disappeared by 24 months, suggesting no clinically meaningful difference associated with adding a Lemaire ALC reconstruction at 24-month follow-up. LEVEL OF EVIDENCE: Level III, retrospective comparative study.