前交叉韧带重建术后感染显著增加长期随访中三间室骨关节炎的风险
简介
该回顾性病例对照研究比较了ACLR术后感染患者与无并发症对照组的长期预后，平均随访16.2年。结果显示感染组7例患者全部（100%）出现三间室骨关节炎（Kellgren-Lawrence≥2级），而对照组仅为35%，但两组间下肢力线、临床评分及关节松弛度无显著差异。提示ACLR术后感染虽未明显影响短期功能，但显著增加远期三间室OA风险，临床应重视围手术期感染…
英文摘要
PURPOSE: To compare the long-term radiographic and clinical outcomes of patients who developed postoperative infection after anterior cruciate ligament reconstruction (ACLR) with those of a matched cohort of patients who underwent uncomplicated ACLR to determine the impact of infection on the development of osteoarthritis (OA) and knee function. METHODS: This retrospective case-controlled comparative study included patients who developed postoperative infection after primary ACLR performed between January 2003 and January 2014. Eligible patients had no baseline OA and a minimum 10-year clinical and radiographic follow-up. A matched group of patients with uncomplicated ACLR served as controls. Radiographic OA was assessed using the Kellgren-Lawrence and Osteoarthritis Research Society International criteria, alignment with the hip-knee-ankle angle, and clinical outcomes with the International Knee Documentation Committee, Lysholm, and Tegner scores and KT-1000 anteroposterior laxity. Statistical comparisons were performed using independent t-tests for continuous variables and Fisher's exact test for categorical outcomes. RESULTS: At a mean follow-up of 16.2 years (range, 14-19 years), all 7 patients who developed postoperative infection showed 3-compartment OA (Kellgren-Lawrence grade ≥2), whereas 35% of the control group developed OA (P = .0058). The hip-knee-ankle angle averaged 4.42° varus in infected knees versus 4.67° varus in control knees (P = .77). No significant differences were observed in clinical scores, anteroposterior laxity, or contralateral knees between groups. CONCLUSIONS: This study shows that postoperative infection after ACLR significantly increases the risk of 3-compartment OA at long-term follow-up compared with uncomplicated ACLR. LEVEL OF EVIDENCE: Level III, retrospective comparative study.