同側ACLグラフトと対側ネイティブACLの引裂率はACL再建後も同様である

Tear Rates of the Ipsilateral ACL Graft and the Contralateral Native ACL Are Similar following ACL Reconstruction.

• Nadia Nastassia Ifran
• Ying Ren Mok
• Lingaraj Krishna

抄録

本研究の目的は、同側の前十字靭帯（ACL）移植片と対側のネイティブACLの断裂率を比較するとともに、性別、手術時の年齢、BMI（body mass index）とこれらの損傷の発生との相関を調べることである。ACL再建手術を受けた751人の患者の医療記録を2～7年の追跡調査期間でレトロスペクティブに分析した。同側のACL移植片と対側のネイティブACLの生存率分析を行った。これらの損傷に関連する危険因子を同定するために、一変量および多変量ロジスティック回帰分析が行われた。同側ACL移植片と対側ACLの断裂率はそれぞれ5.86％と6.66％であり、群間に有意差はなかった（=0.998）。同側ACLと対側ACLの断裂の平均期間も、術後2.64年と2.78年で同様であった（=0.977）。同側ACLグラフトと対側ACL断裂を持続するオッズも、再建を行った年齢が1年上昇するごとに、それぞれ0.10（=0.003）と0.14（=0.000）の有意な減少が認められた。しかし、グラフトの種類、性別、BMIはこれらの損傷のリスクの増加とは関連していなかった。ACL再建後の同側ACLグラフトと対側ACLの断裂率に差はなかった。若年でACL再建を受ける患者は、ACL再建後に同側ACL移植片と対側ACLの両方が破断するリスクが高い。若くして競技スポーツに復帰する可能性が高い患者には、そのリスクを説明し、回復直後からスポーツ復帰までの間、対側の膝のリハビリテーションを怠らないようにアドバイスする必要があります。これはレベルIIIのレトロスペクティブコホート研究です。

The aim of the study is to compare the tear rates of ipsilateral anterior cruciate ligament (ACL) grafts and the contralateral native ACL as well as to investigate the correlation of gender, age at time of surgery, and body mass index (BMI) with the occurrence of these injuries. The medical records of 751 patients who underwent ACL reconstruction surgery with follow-up periods of 2 to 7 years were retrospectively analyzed. Survival analyses of ipsilateral ACL grafts and contralateral native ACL were performed. Univariate and multivariate logistic regression analyses were performed to identify risk factors that were associated with these injuries. The tear rates of the ipsilateral ACL graft and contralateral ACL were 5.86 and 6.66%, respectively with no significant difference between groups ( = 0.998). The mean time of tears of the ipsilateral ACL and contralateral ACL was also similar ( = 0.977) at 2.64 and 2.78 years, respectively after surgery. Both the odds of sustaining an ipsilateral ACL graft and contralateral ACL tear were also significantly decreased by 0.10 ( = 0.003) and 0.14 ( = 0.000), respectively, for every 1-year increase in age at which the reconstruction was performed. However, graft type, gender, and BMI were not associated with an increased risk of these injuries. There was no difference between tear rates of ipsilateral ACL graft and contralateral ACL following ACL reconstruction. Patients who undergo ACL reconstruction at a young age are at an increased risk of both ipsilateral graft and contralateral ACL rupture after an ACL reconstruction. Patients who are young and more likely to return to competitive sports should be counselled of the risks and advised to not neglect the rehabilitation of the contralateral knee during the immediate and back to sports period of recovery. This is a Level III, retrospective cohort study.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.