Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sports Science, Oslo, Norway.
Br J Sports Med. 2016 Aug;50(15):946-51. doi: 10.1136/bjsports-2015-095908. Epub 2016 May 23.
The decision as to whether or not an athlete is ready to return to sport (RTS) after ACL reconstruction is difficult as the commonly used RTS criteria have not been validated.
To evaluate whether a set of objective discharge criteria, including muscle strength and functional tests, are associated with risk of ACL graft rupture after RTS.
158 male professional athletes who underwent an ACL reconstruction and returned to their previous professional level of sport were included. Before players returned to sport they underwent a battery of discharge tests (isokinetic strength testing at 60°, 180° and 300°/s, a running t test, single hop, triple hop and triple crossover hop tests). Athletes were monitored for ACL re-ruptures once they returned to sport (median follow-up 646 days, range 1-2060).
Of the 158 athletes, 26 (16.5%) sustained an ACL graft rupture an average of 105 days after RTS. Two factors were associated with increased risk of ACL graft rupture: (1) not meeting all six of the discharge criteria before returning to team training (HR 4.1, 95% CI 1.9 to 9.2, p≤0.001); and (2) decreased hamstring to quadriceps ratio of the involved leg at 60°/s (HR 10.6 per 10% difference, 95% CI 10.2 to 11, p=0.005).
Athletes who did not meet the discharge criteria before returning to professional sport had a four times greater risk of sustaining an ACL graft rupture compared with those who met all six RTS criteria. In addition, hamstring to quadriceps strength ratio deficits were associated with an increased risk of an ACL graft rupture.
由于常用的 RTS 标准尚未得到验证，因此决定 ACL 重建后运动员是否准备重返运动（RTS）是困难的。
评估一组客观的出院标准，包括肌肉力量和功能测试，与 RTS 后 ACL 移植物破裂的风险是否相关。
纳入了 158 名接受 ACL 重建并重返之前专业运动水平的男性职业运动员。在球员重返运动之前，他们接受了一系列出院测试（60°、180°和 300°/s 的等速力量测试、跑步 t 测试、单跳、三跳和三交叉跳测试）。一旦运动员重返运动，就会对 ACL 再断裂进行监测（中位数随访 646 天，范围 1-2060）。
在 158 名运动员中，26 名（16.5%）在 RTS 后平均 105 天发生 ACL 移植物破裂。有两个因素与 ACL 移植物破裂风险增加相关：（1）在返回团队训练之前未满足所有六项出院标准（HR 4.1，95%CI 1.9 至 9.2，p≤0.001）；（2）患腿 60°/s 时腘绳肌与股四头肌的比率下降（每 10%差异 HR 10.6，95%CI 10.2 至 11，p=0.005）。
与满足所有六项 RTS 标准的运动员相比，在返回职业运动之前未满足出院标准的运动员 ACL 移植物破裂的风险高四倍。此外，腘绳肌与股四头肌力量比不足与 ACL 移植物破裂风险增加相关。
