Rates of Subjective Failure After Both Isolated and Combined Posterior Cruciate Ligament Reconstruction: A Study From the Norwegian Knee Ligament Registry 2004-2021.

Autor:	Moatshe G; Oslo University Hospital and University of Oslo, Oslo, Norway.; Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway., LaPrade CM; OrthoCarolina, Charlotte, North Carolina, USA., Fenstad AM; Norwegian Knee Ligament Registry, Haukeland University Hospital, Bergen, Norway., Persson A; Oslo University Hospital and University of Oslo, Oslo, Norway.; Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway.; Norwegian Knee Ligament Registry, Haukeland University Hospital, Bergen, Norway., LaPrade M; Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Martin RK; Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway.; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.; Department of Orthopedics, CentraCare, St Cloud, Minnesota, USA., Engebretsen L; Oslo University Hospital and University of Oslo, Oslo, Norway.; Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway., LaPrade RF; Twin Cities Orthopedics, Edina, Minnesota, USA.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2024 May; Vol. 52 (6), pp. 1491-1497. Date of Electronic Publication: 2024 Mar 29.
DOI:	10.1177/03635465241238461
Abstrakt:	Background: Outcomes after posterior cruciate ligament (PCL) reconstruction (PCLR) have been reported to be inferior to those of anterior cruciate ligament reconstruction. Furthermore, combined ligament injuries have been reported to have inferior outcomes compared with isolated PCLR. Purpose/hypothesis: The purpose of this study was to report on PCLR outcomes and failure rates and compare these outcomes between isolated PCLR and multiligament knee surgery involving the PCL. The hypothesis was that combined PCL injury reconstruction would have higher rates of subjective failure and revision relative to isolated PCLR. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with primary PCLR with or without concomitant ligament injuries registered in the Norwegian Knee Ligament Registry between 2004 and 2021 were included. Knee injury and Osteoarthritis Outcome Score (KOOS) totals were collected preoperatively and at 2 years and 5 years postoperatively. The primary outcome measure was failure, defined as either a revision surgery or a KOOS Quality of Life (QoL) subscale score <44. Results: The sample included 631 primary PCLR procedures, with 185 (29%) isolated PCLR procedures and 446 (71%) combined reconstructions, with a median follow-up time of 7.3 and 7.9 years, respectively. The majority of patients had poor preoperative knee function as defined by a KOOS QoL score <44 (90.1% isolated PCLR, 85.7% combined PCL injuries; P = .24). Subjective outcomes improved significantly at 2- and 5-year follow-up compared with preoperative assessments in both groups ( P < .001); however, at 2 years, 49.5% and 46.5% had subjective failure (KOOS QoL <44) for isolated PCLR and combined PCLR, respectively ( P = .61). At 5 years, the subjective failure rates of isolated and combined PCLR were 46.7% and 34.2%, respectively ( P = .04). No significant difference was found in revision rates between the groups at 5 years (1.9% and 4.6%, respectively; P = .07). Conclusion: Patients who underwent PCLR had improved KOOS QoL scores relative to their preoperative state. However, the subjective failure rate was high for both isolated and multiligament PCLR. Within the first 2 years after surgery, patients who undergo isolated PCLR can be expected to have similar failure rates to patients who undergo combined ligament reconstructions. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: G.M. and C.M.L. have received fellowship support from Smith & Nephew. M.L. has received support for education from Great Lakes Orthopedics. R.K.M. has received support for education from Arthrex, Foundation Medical, and Gemini Medical and hospitality payments from Smith & Nephew and Medical Device Business Services. L.E. has received research support from Arthrex, Biomet, and Smith & Nephew and consulting fees and royalties from Arthrex; he holds stock or stock options from iBalance. R.F.L. has received research support from Arthrex, Linvatec, Ossur, and Smith & Nephew; royalties from Arthrex, Ossur, and Smith & Nephew; and consulting fees from Ossur and Smith & Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Databáze:	MEDLINE
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