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重返赛场和职业寿命:加拿大职业足球运动员前交叉韧带重建后。

Return to Play and Career Length After Anterior Cruciate Ligament Reconstruction Among Canadian Professional Football Players.

机构信息

Pan Am Clinic, University of Manitoba, Winnipeg, Manitoba, Canada.

University of Saskatchewan, Regina, Saskatchewan, Canada.

出版信息

Am J Sports Med. 2020 Jun;48(7):1682-1688. doi: 10.1177/0363546520918224. Epub 2020 May 7.


DOI:10.1177/0363546520918224
PMID:32379980
Abstract

BACKGROUND: For many athletes, a tear of the anterior cruciate ligament (ACL) represents a significant injury that requires a prolonged period away from the sport with substantial rehabilitation. HYPOTHESIS: There will be no difference in return to play (RTP) and career length after hamstring tendon (HT) ACL reconstruction in a group of Canadian Football League professional players as compared with what has been already been reported in the literature among professional football players. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: Data on athletes who sustained an ACL injury were collected by team physicians and head athletic trainers from 2002 to 2017 from 2 Canadian Football League teams. Patient details included age at the time of injury, initial injury date, position, practice versus game injury, and primary versus rerupture with injury-specific data, such as affected limb, concomitant injuries, graft choice, and procedure performed. RTP rates and career length data were collected through publically available internet sources. Comparisons between the non-RTP and RTP groups were made with independent-sample tests. Binomial logistic regression was performed to determine variables (ie, games preinjury, graft type, meniscal injury, collateral ligament injury) that contributed to players not being able to RTP. RESULTS: A total of 44 ACL reconstructions were performed over the study period (HT, n = 32 [72.7%]; bone-patellar tendon-bone [BPTB], n = 8 [18.2%]; allograft, n = 4 [9.1%]). Overall, 69.8% (n = 30) were able to RTP in at least 1 game, while 30.2% (n = 13) did not return. Mean time to return was 316.1 days (range, 220-427 days), or 10.4 months. For those players who did RTP, mean career length after ACL reconstruction was 2.8 seasons, or 34.4 games. The majority (56.8%) of injuries occurred early in the season. Breakdown by graft type demonstrated RTP rates among HT, BPTB, and allograft of 64.5% (n = 20), 87.5% (n = 7), and 75% (n = 3), respectively. Career length among HT, BPTB, and allograft was 2.9, 2.4, and 3 seasons. Logistic regression analysis found only concomitant medial collateral ligament (MCL) injuries to be a negative predictor for RTP. Meniscal injuries were associated with a decreased RTP rate and career length, but this was not statistically significant. CONCLUSION: The RTP rates after ACL reconstruction in this study are similar to those reported in National Football League players. A concomitant injury to the MCL injury was a negative predictor of RTP. Meniscal injuries demonstrated a trend for decreased RTP rate and career length, but this was not a significant predictor. A large portion of injuries occur early in the season, and further study should be done to examine potential preventative strategies to reduce ACL injuries.

摘要

背景:对于许多运动员来说,前交叉韧带(ACL)撕裂是一种严重的伤害,需要长时间远离运动并进行大量康复。

假设:与文献中已经报道的职业足球运动员相比,在一组加拿大足球联盟职业球员中,跟腱(HT)ACL 重建后重返赛场(RTP)和职业生涯长度不会有差异。

研究设计:病例对照研究;证据水平,3 级。

方法:通过团队医生和首席运动训练师从 2002 年到 2017 年从两支加拿大足球联盟球队收集了遭受 ACL 损伤的运动员的数据。患者详细信息包括受伤时的年龄、初始受伤日期、位置、练习与比赛受伤、初次与再撕裂,以及与损伤特异性相关的数据,例如受累肢体、合并伤、移植物选择和手术方式。通过公开的互联网来源收集 RTP 率和职业生涯长度数据。通过独立样本 t 检验比较非 RTP 和 RTP 组。进行二项逻辑回归以确定不能 RTP 的球员的变量(即,比赛前的比赛、移植物类型、半月板损伤、侧副韧带损伤)。

结果:在研究期间共进行了 44 例 ACL 重建(HT,n = 32 [72.7%];骨-髌腱-骨 [BPTB],n = 8 [18.2%];同种异体移植物,n = 4 [9.1%])。总体而言,69.8%(n = 30)至少能 RTP 一场比赛,而 30.2%(n = 13)无法返回。平均 RTP 时间为 316.1 天(范围,220-427 天),或 10.4 个月。对于那些能够 RTP 的球员,ACL 重建后的平均职业生涯长度为 2.8 个赛季,或 34.4 场比赛。大多数(56.8%)受伤发生在赛季早期。按移植物类型分析,HT、BPTB 和同种异体移植物的 RTP 率分别为 64.5%(n = 20)、87.5%(n = 7)和 75%(n = 3)。HT、BPTB 和同种异体移植物的职业生涯长度分别为 2.9、2.4 和 3 个赛季。逻辑回归分析发现只有合并的内侧副韧带(MCL)损伤是 RTP 的负预测因子。半月板损伤与 RTP 率和职业生涯长度降低相关,但无统计学意义。

结论:本研究中 ACL 重建后的 RTP 率与 NFL 球员报道的相似。MCL 损伤是 RTP 的负预测因子。半月板损伤显示 RTP 率和职业生涯长度降低的趋势,但不是显著的预测因子。大部分损伤发生在赛季早期,应进一步研究潜在的预防策略以减少 ACL 损伤。

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