REVISION ANTERIOR CRUCIATE LIGAMENT (ACL) RECONSTRUCTION OUTCOMES ARE SIGNIFICANTLY LOWER THAN PRIMARY ACL RECONSTRUCTION: WHAT SHOULD WE ADVISE OUR PATIENTS?
Notice bibliographique
Résumé
The increase in annual rates of ACL reconstruction (ACL-R) includes both primary and revision procedures. Similar to primary ACL-R, Revision ACL (Re-ACL) patients undergo surgery with the intent to improve function with daily activities including returning to sport or recreational activities. The primary purpose of this study was to compare the objective clinical, functional, and quality of life outcomes of patients following Re-ACL with a matched cohort of unilateral primary ACL-R, to facilitate improved counselling of patients regarding expected outcomes following surgery. Prospectively collected patient data from a single center was utilized for this study. Re-ACL and primary ACL-R patients were matched for sex, age at the time of surgery within 12-months, body mass index (BMI) within two kg and Beighton score. Patient demographics, injury, and operative data were collected. All patients completed functional assessment at 24-months post-operative including balance and hop testing. The anterior cruciate ligament quality of life questionnaire (ACL-QOL) was completed pre-operatively and 24-months post-operatively. Descriptive statistics, paired t-tests and one-way ANOVA were utilized to assess between group differences. A total of 470 patients were included, 235 each Re-ACL and ACL-R. There were 122 males and 113 females per group, mean age was 30.7 years, mean BMI was 25.3 kg/m2, and the median Beighton score was three. At 24-months post-operative graft failure occurred in 24/235 (10.2%), of the Re-ACL compared to 2/235 (0.9%) of the ACL-R cohort (p<.05). Laxity as assessed by positive Lachman and Pivot-shit tests was 66/235 (28.1%) and 36/235 (15.3%) respectively for Re-ACL compared with 38/235 (16.2%) and 11/235 (4.7%) for ACL-R (p<.05). Functional assessment indicated statistically significant differences in single leg balance and single-leg hop test performance with 108/235 (46%) achieving 90% limb symmetry for Re-ACL compared with 202/235 (86%) for ACL-R (p<.01). Rate of return to sport or activity was 54% for Re-ACL compared with 92% for ACL-R. The pre to post ACL-QOL scores improved from 29.5 to 61.3 for Re-ACL and 27.5 to 76.0 for ACL-R. One-way ANOVA demonstrated statistically significant between group differences in post-operative ACL-QOL scores, f = 55.3, p< .001. In this matched-cohort study comparing outcomes at 24-months post-operative, Re-ACL demonstrated statically significantly higher rates of failure and residual laxity, lower achievement of limb symmetry and return to sport, and lower disease-specific QOL. In counselling patients regarding Re-ACL surgery, strong consideration should be given to discussing clinical, functional and QOL outcomes to help manage patient expectations.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,002 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».