Sharon L. Hame, Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, CHS 76-119, 10833 LeConte Avenue, Los Angeles, CA 90095-6902, USA.
Am J Sports Med. 2014 Apr;42(4):959-64. doi: 10.1177/0363546513519951. Epub 2014 Feb 11.
High school and professional athletes with a history of orthopaedic surgery have decreased career lengths and are at a greater risk for reinjury compared with their peers. It is unknown whether the same risk applies to intercollegiate athletes.
To determine the effect of prior knee surgery in National Collegiate Athletic Association (NCAA) Division I athletes in the United States.
Cohort study; Level of evidence, 3.
Division I athletes who began participation in collegiate athletics at a single institution from fall 2003 to spring 2008 were identified. Athletes with a history of orthopaedic surgery were identified through preparticipation evaluation forms. Data on the number of seasons and games played, number of days missed, diagnostic imaging, athletic injuries sustained, and surgical operations during college were collected through medical records and the Sports Injury Monitoring System (SIMS).
During the 5-year study period, 456 athletes completed preparticipation evaluation forms. Of these, 104 athletes (22.8%) had a history of orthopaedic surgery (Ortho group). Forty-eight (10.5% of all athletes) had a history of knee surgery (Knee group), 16 (3.5%) had a history of anterior cruciate ligament reconstruction (ACL group), and 28 (6.1%) had a history of multiple surgeries (Multiple group). Days missed per season due to any injury and due to knee injury were increased for all surgical groups compared with controls (P < .016). The rate of knee injury and knee surgery while in college was significantly increased for all surgery groups. Athletes in the Knee and ACL groups were 6.8- and 19.6-fold more likely to sustain a knee injury and 14.4- and 892.9-fold more likely to undergo a knee surgery during their collegiate careers compared with controls (P < .001). The number of MRIs per season were 0.83 for the Knee group (P < .001), 1.29 for the ACL (P = .009), and 0.97 for the Multiple group (P < .001), compared with 0.37 for controls. Average career length and percentage of games played were not significantly different between any of the surgery groups compared with controls.
Athletes who had a history of knee surgery before participation in collegiate athletics miss more days due to injury, have increased rates of knee injury and knee surgery, and require more MRIs during their collegiate careers than their peers.
与同龄人相比，有过矫形外科手术史的高中生和职业运动员的职业生涯缩短，再次受伤的风险更高。目前尚不清楚这种风险是否同样适用于大学生运动员。
确定美国国家大学体育协会（NCAA）一级运动员中既往膝关节手术的影响。
队列研究；证据水平，3 级。
确定了 2003 年秋季至 2008 年春季期间在一所院校开始参加大学生体育活动的一级运动员。通过参赛前评估表确定有矫形外科手术史的运动员。通过病历和运动伤害监测系统（SIMS）收集了关于赛季和比赛次数、缺课天数、诊断成像、运动损伤以及大学期间手术的数据。
在 5 年的研究期间，有 456 名运动员完成了参赛前评估表。其中，104 名运动员（22.8%）有矫形外科手术史（矫形组）。48 名运动员（所有运动员的 10.5%）有膝关节手术史（膝关节组），16 名运动员（3.5%）有前交叉韧带重建史（ACL 组），28 名运动员（6.1%）有多次手术史（多发组）。与对照组相比，所有手术组因任何损伤和膝关节损伤导致的每个赛季缺课天数均增加（P<.016）。所有手术组的膝关节损伤和膝关节手术率在大学期间均显著增加。与对照组相比，膝关节组和 ACL 组的运动员在大学期间发生膝关节损伤的可能性分别增加了 6.8 倍和 19.6 倍，接受膝关节手术的可能性分别增加了 14.4 倍和 892.9 倍（P<.001）。膝关节组每赛季的 MRI 数量为 0.83（P<.001），ACL 组为 1.29（P=.009），多发组为 0.97（P<.001），而对照组为 0.37。与对照组相比，任何手术组的平均职业寿命和比赛参与率均无显著差异。
与同龄人相比，在参加大学生体育活动之前接受过膝关节手术的运动员因受伤而缺课的天数更多，膝关节损伤和膝关节手术的发生率更高，并且在大学期间需要进行更多的 MRI 检查。
