Development of heterotopic ossification after multiple-ligament reconstruction of the knee joint: Incidence and explanatory factor analysis
| Autor: | Jin Zhang, Guanyang Song, Hua Feng |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Knee Dislocation Knee Joint Posterior Cruciate Ligament Reconstruction 030209 endocrinology & metabolism Knee Injuries Young Adult 03 medical and health sciences 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine 030222 orthopedics business.industry Incidence Ossification Heterotopic Plastic Surgery Procedures musculoskeletal system medicine.disease Surgery medicine.anatomical_structure Concomitant Ligaments Articular Cohort Ligament Female Heterotopic ossification Factor Analysis Statistical business Range of motion |
| Zdroj: | The Knee. 27:642-648 |
| ISSN: | 0968-0160 |
| DOI: | 10.1016/j.knee.2020.04.012 |
| Popis: | The development of heterotopic ossification (HO) might nullify any benefit of multiple-ligament reconstruction of the knee joint. The purpose of this study was to investigate the incidence and the specific explanatory factors for the development of HO after multiple-ligament reconstruction of the knee joint.From January 2011 to June 2016, 72 consecutive patients with knee dislocations received multiple-ligament reconstructions, of which 57 (79%) were available for a minimum follow up of 12 months and were included in this study. Anteroposterior (AP) and lateral radiographs were reviewed for all patients. This knee dislocation cohort was separated into two groups based on the presence or absence of HO for comparisons. In addition, the HO group was divided into three subgroups based on a modified quadrant grading system introduced by the senior author for further evaluation. Multivariate logistic regression analysis was then performed to identify specific explanatory factors predicting development of HO in patients after multiple-ligament reconstructions of the knee joint.Among the 72 consecutive patients, 57 (79%) were available for the clinical evaluations with an average period of 28.4 months (range, 12-51 months). Twenty-one patients (37%) showed radiological evidence of HO. The HO group (n = 21) showed significantly inferior results of knee flexion angle compared with the non-HO group (n = 36) (HO group vs. non-HO group: 124 ± 13° vs. 132 ± 5°; P0.01). According to the quadrant grading system, there were seven patients with grade I, nine with grade II, and five with grade III HO. Subgroup analysis further revealed that higher HO grade would lead to lower knee flexion angle. In addition, multivariate regression analysis showed that concomitant posterior cruciate ligament reconstruction was the only independent explanatory factor predicting the development of HO after multiple-ligament reconstruction of the knee joint (P=0.018; odds ratio, 8.75; 95% confidence interval, 1.69-39.7).In this cohort of knee dislocations, the incidence of HO development following multiple-ligament reconstruction was 37%, with grade III HO showing the most inferior range of motion outcome. Moreover, concomitant posterior cruciate ligament reconstruction was the only independent predictor for the development of HO. |
| Databáze: | OpenAIRE |
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