Aune Kyle T, Andrews James R, Dugas Jeffrey R, Cain E Lyle
American Sports Medicine Institute, Birmingham, Alabama, USA
American Sports Medicine Institute, Birmingham, Alabama, USA.
Am J Sports Med. 2014 Aug;42(8):1865-72. doi: 10.1177/0363546514535069. Epub 2014 Jun 9.
Lateral meniscal injury is a common and possibly career-threatening injury among players in the National Football League (NFL). The rate of return to play (RTP) and factors that affect RTP after lateral meniscal injury in NFL players are currently not defined.
The aims of this study were to determine the rate of RTP to regular-season NFL game play of NFL players after arthroscopic partial lateral meniscectomy and to identify factors that can predict the ability to return to play.
Case series; Level of evidence, 4.
Seventy-two patients undergoing 77 arthroscopic lateral partial meniscectomies were followed to determine the rate of RTP (defined as successful RTP in at least 1 regular-season NFL game after meniscectomy) and factors predicting players' ability to return to play. Perioperative variables were recorded using retrospective chart review. Players' heights and weights, dates of return, draft rounds, and counts of games, starts, and seasons both before and after meniscectomy were all collected from statistical databases maintained by the NFL. Chi-square and Student t tests were performed to assess differences among covariates with respect to an athlete's ability to return to play, and odds ratios were calculated as appropriate. All percentages were calculated as percent of total procedures performed (n = 77).
Of the 77 partial lateral meniscectomies performed, 61% (n = 47) resulted in the athlete returning to play at his previous level of competition with an average length of time to RTP of 8.5 months; 19 (40%) of those who returned were still active in the NFL at the time of follow-up. Age at time of surgery, games and seasons played before surgery, and individual position were not significantly different between those who did and did not return to play. Undergoing a concomitant procedure did not affect an athlete's ability to return to play, nor did concurrent arthroscopic anterior cruciate ligament reconstruction affect a player's likelihood to return to play. Players drafted in the first 4 rounds of the NFL draft were 3.7 times more likely to return to play than players drafted after the fourth round, and players who started more than 46.2% of their games played (the mean value for this population) were 2.8 times more likely to return to play. Speed-position players (running backs, receivers, linebackers, and defensive backs) were 4.0 times less likely to return to play than non-speed position players (linemen and tight ends).
The majority of NFL players undergoing arthroscopic lateral meniscectomy are able to return to play. Players selected earlier in the NFL draft and who are listed as starters in more of their games are more likely to return to play, as are linemen and tight ends. It is significantly more difficult for running backs, receivers, linebackers, and defensive backs to return to play.
外侧半月板损伤在国家橄榄球联盟（NFL）球员中是一种常见且可能危及职业生涯的损伤。目前，NFL球员外侧半月板损伤后的重返赛场率（RTP）以及影响RTP的因素尚未明确。
本研究旨在确定接受关节镜下外侧半月板部分切除术的NFL球员重返常规赛的RTP，并识别能够预测其重返赛场能力的因素。
病例系列；证据等级，4级。
对72例行77次关节镜下外侧半月板部分切除术的患者进行随访，以确定RTP率（定义为半月板切除术后至少在1场常规赛中成功重返赛场）以及预测球员重返赛场能力的因素。通过回顾性病历审查记录围手术期变量。球员的身高、体重、回归日期、选秀轮次以及半月板切除术前和术后的比赛场次、首发次数和赛季数均从NFL维护的统计数据库中收集。进行卡方检验和学生t检验以评估协变量在运动员重返赛场能力方面的差异，并在适当情况下计算比值比。所有百分比均按所执行的总手术例数（n = 77）计算。
在77例外侧半月板部分切除术中，61%（n = 47）的运动员能够以之前的竞技水平重返赛场，平均RTP时间为8.5个月；其中19名（40%）重返赛场的运动员在随访时仍活跃于NFL。手术时的年龄、术前的比赛场次和赛季数以及个人位置在重返赛场和未重返赛场的运动员之间无显著差异。同时进行其他手术并不影响运动员重返赛场的能力，但同时进行关节镜下前交叉韧带重建也不影响球员重返赛场的可能性。在NFL选秀前4轮被选中的球员重返赛场的可能性是在第四轮之后被选中球员的3.7倍，并且首发比赛场次超过其总比赛场次46.2%（该人群的平均值）的球员重返赛场的可能性是其他球员的2.8倍。速度型位置球员（跑卫、接球手、线卫和防守后卫）重返赛场的可能性比非速度型位置球员（前锋和近端锋）低4.0倍。
大多数接受关节镜下外侧半月板切除术的NFL球员能够重返赛场。在NFL选秀中较早被选中且在更多比赛中担任首发的球员更有可能重返赛场，前锋和近端锋也是如此。跑卫、接球手、线卫和防守后卫重返赛场的难度明显更大。
