Hooghof, J.Th. (Arjan) (2013) Transplantaatoverleving na een voorste kruisband reconstructie en het klinisch functioneren van de knie na minimaal 5 jaar follow-up. thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
HooghofJ.pdf Restricted to Registered users only Download (1MB) |
Abstract
Background: An anterior cruciate ligament (ACL) reconstruction is a commonly performed procedure after an ACL rupture. The aim of reconstruction is to restore the stability of the knee by replacing the ruptured ACL. An ACL rupture may result in severe functional limitations and factors that increase the risk of this injury are frequently investigated. However, less is known about the incidence and risks of graft rupture after ACL reconstruction. Variables such as age, sex, graft material and activity level may affect graft survival. In addition, little is known about the level of knee functioning after ACL reconstruction, graft rupture and revision of the graft. Objective: The aim of this study was to assess the incidence of graft rupture after ACL reconstruction. Variables that may affect graft survival and the physical function of the knee were also investigated. Study design: Cohort study Methods: Data was collected from digital medical files of patients who had undergone an ACL reconstruction in the Martini hospital between December 1st 2004 and July 1st 2008. Patients received a questionnaire with questions involving date of the initial rupture, sports level, return to the sports, graft rupture, revision ACL reconstruction and satisfaction of knee functioning. The questionnaires IKDC, KOOS and SARS were used to estimate activity level and physical functioning. Kaplan-Meier curves and Cox regression analysis were used to evaluate graft surival. Fisher's exact test and independent T-test were used to determine the variables affecting graft survival and the physical functioning of the knee. Results: A total of 456 patients were included in this study, of which 212 patients returned the questionnaires (46,5%). Among the population were 133 men (62,7%) and 79 women (37,3%). ACL graft rupture occurred in 17 patients (8%). Graft survival was estimated at 92% after a minimum follow-up time of 5 years. The incidence of graft rupture did not significantly differ between sexes (p=0,38), graft material (p=0,68), and age groups (< 25 years p=0,43, 25-30 years p=0,49, > 30 years p=1,00). However, women were more likely to rupture a hamstring tendon graft in the age category <25 years (Hazard Ratio = 2,98, CI 0,62 – 14,7), though this was not significant (p=0,17). A higher sports level prior to ACL reconstruction (p=0,004) and experience of the surgeon (p=0,02) seem to affect graft survival. A graft rupture after ACL reconstruction resulted in worse functioning on each of the KOOS subscales (p<0,001 to p=0,02). Revision ACL reconstruction following graft rupture resulted in better knee functioning compared to the group without revision, but did not appear to be significantly different (p=0,13 to p=0,66). Conclusion: After an ACL reconstruction with a minimum follow-up of 5 years, graft failure was found in 8% of the patient population. A higher sports level prior to the ACL reconstruction and experience of the surgeon seemed to affect graft survival. Revision after graft rupture resulted in poorer physical function compared to a primary ACL reconstruction.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Raaij, dr. J.J.A.M. van and Reininga, dr. I.H.F. and Martini ziekenhuis, Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2119 |
Actions (login required)
 |
View Item |