Serner Andreas, Weir Adam, Tol Johannes L, Thorborg Kristian, Lanzinger Sean, Otten Roald, Hölmich Per
Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
Center for Groin Injuries, Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, the Netherlands.
Orthop J Sports Med. 2020 Jan 29;8(1):2325967119897247. doi: 10.1177/2325967119897247. eCollection 2020 Jan.
Despite being one of the most common sports injuries, there are no criteria-based rehabilitation programs published for acute adductor injuries.
To evaluate return-to-sport (RTS) outcomes and reinjuries after criteria-based rehabilitation for athletes with acute adductor injuries.
Cohort study; Level of evidence, 2.
Male adult athletes with an acute adductor injury underwent a supervised, standardized criteria-based exercise rehabilitation program. Magnetic resonance imaging (MRI) was used to grade the injury extent from 0 (negative finding) to 3 (complete tear/avulsion). There were 3 milestones used to evaluate the RTS continuum: (1) clinically pain-free, (2) completion of controlled sports training, and (3) return to full team training. Subsequent injuries were registered within the first year.
We included 81 athletes with an acute adductor injury (MRI grade 0: n = 14; grade 1: n = 20; grade 2: n = 30; grade 3: n = 17). Of these, 61 (75%) athletes achieved RTS milestone 1, 50 (62%) achieved RTS milestone 2, and 75 (93%) achieved RTS milestone 3. There were no statistical differences in the RTS duration between MRI grade 0, 1, and 2 at any RTS milestone; thus, these were grouped together as grade 0-2. The median time (interquartile range [IQR]) for athletes with grade 0-2 injuries to become clinically pain-free was 13 days (IQR, 11-21 days), to complete controlled sports training was 17 days (IQR, 15-27 days), and to return to full team training was 18 days (IQR, 14-27 days). For athletes with a grade 3 injury, median times were 55 days (IQR, 31-75 days), 68 days (IQR, 51-84 days), and 78 days (IQR, 68-98 days), respectively. The overall 1-year reinjury rate was 8%. Athletes who achieved RTS milestone 1 had a statistically significantly lower reinjury rate than athletes who did not (5% vs 21%, respectively; ϕ = -0.233; = .048). Athletes who achieved RTS milestone 2 had a nonstatistically significantly lower reinjury rate than athletes who did not (6% vs 13%, respectively; ϕ = -0.107; = .366).
We analyzed the results of a criteria-based rehabilitation protocol for athletes with acute adductor injuries. Athletes with an MRI grade 0-2 adductor injury were clinically pain-free after approximately 2 weeks and returned to full team training after approximately 3 weeks. Most athletes with an MRI grade 3 adductor injury were pain-free and returned to full team training within 3 months. Meeting the clinically pain-free criteria resulted in fewer reinjuries compared with not meeting the criteria.
尽管急性内收肌损伤是最常见的运动损伤之一，但目前尚无基于标准的康复方案发表。
评估急性内收肌损伤运动员基于标准的康复治疗后的重返运动（RTS）结果和再损伤情况。
队列研究；证据等级，2级。
患有急性内收肌损伤的成年男性运动员接受了一项有监督的、标准化的基于标准的运动康复方案。磁共振成像（MRI）用于将损伤程度从0级（阴性结果）分级到3级（完全撕裂/撕脱）。有3个里程碑用于评估RTS连续过程：（1）临床无痛，（2）完成控制性运动训练，（3）恢复全队训练。在第一年记录后续损伤情况。
我们纳入了81名急性内收肌损伤的运动员（MRI 0级：n = 14；1级：n = 20；2级：n = 30；3级：n = 17）。其中，61名（75%）运动员达到了RTS里程碑1，50名（62%）达到了RTS里程碑2，75名（93%）达到了RTS里程碑3。在任何RTS里程碑上，MRI 0级、1级和2级之间的RTS持续时间无统计学差异；因此，这些被归为0 - 2级。0 - 2级损伤的运动员临床无痛的中位时间（四分位间距[IQR]）为13天（IQR，11 - 21天），完成控制性运动训练的时间为17天（IQR，15 - 27天），恢复全队训练的时间为18天（IQR，14 - 27天）。对于3级损伤的运动员，中位时间分别为55天（IQR，31 - 75天）、68天（IQR，51 - 84天）和78天（IQR，68 - 98天）。总体1年再损伤率为8%。达到RTS里程碑1的运动员再损伤率在统计学上显著低于未达到的运动员（分别为5%和21%；ϕ = -0.233；P = .048）。达到RTS里程碑2的运动员再损伤率低于未达到的运动员，但无统计学意义（分别为6%和13%；ϕ = -0.107；P = .366）。
我们分析了急性内收肌损伤运动员基于标准的康复方案的结果。MRI 0 - 2级内收肌损伤的运动员在大约2周后临床无痛，并在大约3周后恢复全队训练。大多数MRI 3级内收肌损伤的运动员在3个月内无痛并恢复全队训练。与未达到标准相比，达到临床无痛标准的运动员再损伤较少。
