Outcomes of Surgical Treatment for Multiligament Knee Injuries in a Cohort Including Competitive Athletes With Long-Term Follow-Up.

Autor:	Mussell EA; Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.; The American Sports Medicine Institute, Birmingham, Alabama, USA., Crawford AE; Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.; The American Sports Medicine Institute, Birmingham, Alabama, USA., Ithurburn MP; The American Sports Medicine Institute, Birmingham, Alabama, USA.; Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA., Layton BO; Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.; The American Sports Medicine Institute, Birmingham, Alabama, USA., Fleisig GS; The American Sports Medicine Institute, Birmingham, Alabama, USA., Rothermich MA; Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.; The American Sports Medicine Institute, Birmingham, Alabama, USA., Emblom BA; Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.; The American Sports Medicine Institute, Birmingham, Alabama, USA., Ryan MK; Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.; The American Sports Medicine Institute, Birmingham, Alabama, USA.; Prevea Health Orthopaedics and Sports Medicine, Green Bay, Wisconsin, USA., Dugas JR; Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.; The American Sports Medicine Institute, Birmingham, Alabama, USA., Andrews JR; Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.; The American Sports Medicine Institute, Birmingham, Alabama, USA., Cain EL Jr; Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama, USA.; The American Sports Medicine Institute, Birmingham, Alabama, USA.
Jazyk:	angličtina
Zdroj:	Orthopaedic journal of sports medicine [Orthop J Sports Med] 2024 Sep 04; Vol. 12 (9), pp. 23259671241266619. Date of Electronic Publication: 2024 Sep 04 (Print Publication: 2024).
DOI:	10.1177/23259671241266619
Abstrakt:	Background: There is a paucity of outcomes data on surgical reconstruction for multiligament knee injury (MLKI) in the orthopaedic literature. Purpose: To examine functional and return-to-sports (RTS) outcomes and revision rates after single-stage reconstruction for MLKIs in a cohort containing a large proportion of competitive athletes over a 20-year period. Study Design: Case series; Level of evidence, 4. Methods: We identified all patients at our institution who underwent surgical reconstruction for an anterior cruciate ligament (ACL) or bicruciate (ACL-posterior cruciate ligament) MLKI between 2001 and 2020 and had ≥2 years of postoperative outcome data. Patient-reported outcomes were evaluated using the International Knee Documentation Committee (IKDC) form, a surgical satisfaction survey, and questions about subsequent knee surgery and RTS administered via telephone. Summary statistics for all outcomes data were calculated, and predictors of IKDC scores at follow-up were examined using univariable linear regression. Results: Out of 151 patients eligible for this study, outcomes data were collected in 119 patients (79%). The mean follow-up time was 8.3 ± 4.4 years, and the mean IKDC score at follow-up was 79 ± 17. A total of 83 competitive athletes were included; 62 of these athletes attempted to return to preinjury sport. Among the 62 who attempted RTS, 50 (81%) were successful, and 12 were unable to return due to limitations from their surgery. At follow-up, 112 of the overall cohort of 119 patients (94%) were either satisfied or very satisfied with their surgical outcome, and 91% stated the surgery met or exceeded their expectations. In addition, 24% had subsequent ipsilateral knee operations after their index multiligament knee reconstruction. Older age at surgery and female sex were associated with worse IKDC scores at follow-up. Conclusion: Despite the severity of the injuries in our cohort, we found high levels of patient-reported function and a high rate of successful RTS in the competitive athletes. Older age and female sex were associated with worse patient-reported knee function at follow-up. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: M.A.R. has received education payments from Arthrex, Smith + Nephew, and Zimmer Biomet; consulting fees from Zimmer Biomet; and nonconsulting fees from Arthrex. B.A.E. has received consulting fees, nonconsulting fees, and royalties from Arthrex. M.K.R. has received grant support from Arthrex; education payments from Arthrex, DJO, Fones Marketing Management, and Smith & Nephew; consulting fees and nonconsulting fees from Arthrex and Zimmer Biomet; and hospitality payments from Linvatec and Prime Surgical. J.R.D. has received consulting fees from Arthrex, Bioventus, DJO, Royal Biologics, and Smith + Nephew; nonconsulting fees from Arthrex; royalties from Arthrex and In2Bones; and hospitality payments from Stryker. J.R.A. has received nonconsulting fees from Arthrex. E.L.C. has received education payments from Prime Surgical and Zimmer Biomet; consulting fees from Arthrex, DJO, Smith + Nephew, and Zimmer Biomet; nonconsulting fees from Arthrex, Medical Device Business Services, and Smith + Nephew; royalties from Arthrex; and hospitality payments from Encore Medical. 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. Ethical approval for this study was obtained from SterlingIRB (ref No. 9023-ELCain). (© The Author(s) 2024.)
Databáze:	MEDLINE
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