Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Sportrehab, Sport Medicine Clinic, Gothenburg, Sweden.
Am J Sports Med. 2018 Jun;46(7):1551-1558. doi: 10.1177/0363546518765120. Epub 2018 Apr 16.
There is insufficient knowledge about the way that concomitant injuries affect the short-term likelihood of a return to a knee-strenuous sport after anterior cruciate ligament (ACL) reconstruction. Hypotheses/Purpose: The purpose was to study whether patient characteristics, concomitant injuries, and graft choice at primary ACL reconstruction can predict return to sport (RTS) 1 year after surgery. The hypotheses were that younger age at the time of ACL reconstruction would positively affect RTS, while the presence of concomitant injuries would negatively affect RTS 1 year after surgery.
Case-control study; Level of evidence, 3.
Data were extracted from a rehabilitation-specific register and the Swedish National Knee Ligament Register. Twelve months after surgery, all patients were evaluated for RTS via the Tegner Activity Scale. The primary outcome was a return to knee-strenuous sport, defined as a Tegner Activity Scale ≥6. Univariable and multivariable logistic regression analyses were performed with patient characteristics, concomitant knee injuries, and graft choice as independent variables.
A total of 272 patients (51% female) with a mean ± SD age of 25.0 ± 9.2 years were included. In the multivariable analysis, a favorable odds ratio (OR) for returning to sport was found for patients of male sex (OR, 2.58; 95% CI, 1.43-4.65; P = .0016), younger age at the time of ACL reconstruction (OR, 2.32; 95% CI, 1.59-3.33; P < .0001), a higher preinjury score on the Tegner Activity Scale (OR, 1.45; 95% CI, 1.13-1.87; P = .0038), and an absence of injury to the meniscus (OR, 1.92; 95% CI, 1.10-3.36; P = .023) and medial collateral ligament (OR, 7.61; 95% CI, 1.42-40.87; P = .018). In addition, the absence of cartilage injury was favorable in terms of RTS in the univariable analysis (OR, 2.48; 95% CI, 1.40-4.39; P = .0018).
Positive predictors of a return to knee-strenuous sport 1 year after ACL reconstruction were male sex, younger age, a high preinjury level of physical activity, and the absence of concomitant injuries to the medial collateral ligament and meniscus.
对于前交叉韧带（ACL）重建后，伴随损伤对短期内重返膝关节剧烈运动的可能性的影响，我们的了解还不够充分。
假设/目的：本研究旨在探讨患者特征、伴随损伤以及初次 ACL 重建时的移植物选择是否可以预测术后 1 年的运动重返（RTS）。假设为 ACL 重建时年龄较小会对 RTS 产生积极影响，而伴随损伤的存在则会对术后 1 年的 RTS 产生负面影响。
病例对照研究；证据水平，3 级。
从康复特定登记处和瑞典膝关节韧带登记处提取数据。术后 12 个月，所有患者均通过 Tegner 活动量表评估 RTS。主要结局是重返膝关节剧烈运动，定义为 Tegner 活动量表≥6。使用患者特征、伴随膝关节损伤和移植物选择作为自变量进行单变量和多变量逻辑回归分析。
共纳入 272 例患者（51%为女性），平均年龄为 25.0±9.2 岁。多变量分析显示，男性（比值比 [OR]，2.58；95%置信区间 [CI]，1.43-4.65；P =.0016）、ACL 重建时年龄较小（OR，2.32；95% CI，1.59-3.33；P<0.0001）、术前 Tegner 活动量表评分较高（OR，1.45；95% CI，1.13-1.87；P =.0038）、半月板（OR，1.92；95% CI，1.10-3.36；P =.023）和内侧副韧带（OR，7.61；95% CI，1.42-40.87；P =.018）无损伤以及软骨无损伤与术后 1 年重返膝关节剧烈运动相关。此外，在单变量分析中，RTS 时无软骨损伤也是有利的（OR，2.48；95% CI，1.40-4.39；P =.0018）。
ACL 重建后 1 年重返膝关节剧烈运动的阳性预测因素为男性、年龄较小、较高的术前身体活动水平，以及内侧副韧带和半月板无伴随损伤。
