骨骼发育未成熟（≤13岁）儿童前交叉韧带重建术后的临床结局与重返运动率：本队列中女性运动员重返运动失败率更高
简介
本研究回顾了29名13岁及以下骨骼未成熟患者ACL重建术后平均65.6个月的随访结果，发现76%的患者重返相同或更高水平运动，但女性患者未重返运动率（45%）高于男性（11%），最常见原因为对再损伤的恐惧。术后同侧再断裂率为10%，平均IKDC评分94.4。临床提示：该年龄段手术功能结局满意，但需与家属充分沟通约10%的再断裂风险及性别间重返运动差异。
英文摘要
INTRODUCTION: The volume of Anterior Cruciate Ligament (ACL) Reconstruction surgery has increased worldwide, however there remains a paucity of information relating to clinical outcomes in skeletally immature paediatric patients aged 13 years or less. METHODS: Twenty-nine patients aged 13 years or less who underwent ACL reconstruction surgery over a 9-year period at our unit with minimum 2 year follow up were contacted. Data recorded included re-rupture, return to sport and functional outcomes in terms of Internal Knee Documentation Committee and Tegner scores. The mean age at time of reconstruction surgery was 12 years and 9 months, with mean follow up 65.6 months. RESULTS: Twenty-two (76%) patients returned to sport at the same level or higher, at mean 12.9 months post reconstruction, median 12 months. An analysis of those seven patients (24%) who did not return to sport showed a higher failure to return rate amongst female (45%), than male patients (11%), p=0.071. The most common contributory reason cited for failure to return to sport was fear of re-injury which was cited as a factor by each patient who did not return. The mean International Knee Documentation Committee (IKDC) score was 94.4 and Tegner index level of activity declined from mean 8.7 to 7.8. Three patients (10%) experienced an ipsilateral re-rupture post ACL reconstruction. This occurred at mean 56 months (45-63) post reconstruction. One patient (3%) experienced a contralateral ACL rupture. CONCLUSION: We have shown that satisfactory clinical outcomes are attainable following ACL reconstruction surgery in young skeletally immature patients aged 13 years or less, however ipsilateral re-rupture rates observed up to 10% require advance discussion with patients and caregivers. Variation in return to play rates seen between genders in our sample may be further elucidated in future studies with larger patient numbers. LEVEL OF EVIDENCE: IV.