前交叉韧带重建采用骨-髌腱-骨移植物与采用腘绳肌腱移植物相比，能够更早、更高地恢复运动。
Anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft is associated with higher and earlier return to sports as compared to hamstring tendon graft.
机构信息
Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2020 Nov;28(11):3659-3665. doi: 10.1007/s00167-020-06074-6. Epub 2020 May 24.
PURPOSE
To study the effect of age, duration of injury, type of graft and concomitant knee injuries on return to sports after anterior cruciate ligament (ACL) reconstruction.
METHOD
One-hundred and sixteen athletes underwent ACL reconstruction using either bone-patellar tendon-bone graft (BPTB; n = 58) or semitendinosus-gracilis graft (n = 58), depending upon their random number sequences. Five variables were analyzed in terms of their effect on return to sports-age, type of graft, time interval between injury and surgery, chondral damage and meniscal tears.
RESULTS
Fifty-three out of 73 (72.6%) athletes aged between 16 and 25 years and 21/43 (49%) athletes aged between 25 and 40 years returned to sports (p = 0.02). The mean time to return to sports was 9.7 ± 2.1 months and 10.8 ± 1.7 months in athletes aged < 25 years and 25-40 years, respectively (p = 0.04). ACL reconstruction with BPTB graft (43/58) was associated with higher rate of return to sports as compared to hamstring tendon graft (31/58; p = 0.02). The mean duration of return to sports with BPTB and STGPI graft was 9.7 ± 2.0 months and 10.7 ± 2.0 months, respectively (p = 0.02). 29/36 (80.5%) patients operated between 2 and 6 months, 18/29 (62%) operated in < 2 months, and 27/51 (53%) operated after 6 months of injury had returned to sports (p = 0.03). Athletes who were operated within 2 months of the injury were the earliest to return to sports (9.4 ± 2.1 months), followed by those operated within 2-6 months (9.9 ± 1.9 months) and lastly by the ones operated after 6 months of the injury (10.9 ± 2.1 months; p = 0.04).
CONCLUSIONS
The rate of return to sports was observed to be higher in athletes younger than 25 years as compared to older athletes (> 25 years). ACL reconstruction with BPTB graft was associated with higher and earlier returns to sports as compared to hamstring graft. The rate of return to sports was highest if surgery was performed between 2 and 6 months after the injury.
LEVEL OF EVIDENCE
III.
目的
研究年龄、受伤持续时间、移植物类型和合并膝关节损伤对前交叉韧带（ACL）重建后重返运动的影响。
方法
116 名运动员接受 ACL 重建，使用骨-髌腱-骨（BPTB；n=58）或半腱肌-股薄肌（n=58）移植物，具体取决于他们的随机数序列。分析了 5 个变量对重返运动的影响：年龄、移植物类型、受伤与手术之间的时间间隔、软骨损伤和半月板撕裂。
结果
53 名 16-25 岁的运动员和 21 名 25-40 岁的运动员重返运动（72.6% vs. 49%；p=0.02）。<25 岁的运动员和 25-40 岁的运动员的平均重返运动时间分别为 9.7±2.1 个月和 10.8±1.7 个月（p=0.04）。BPTB 移植物重建 ACL（43/58）与腘绳肌腱移植物重建 ACL（31/58）相比，重返运动的比例更高（p=0.02）。BPTB 和 STGPI 移植物的平均重返运动时间分别为 9.7±2.0 个月和 10.7±2.0 个月（p=0.02）。29/36（80.5%）名患者在 2-6 个月之间接受手术，18/29（62%）名患者在<2 个月内接受手术，27/51（53%）名患者在受伤后 6 个月以上接受手术（p=0.03）。受伤后 2 个月内接受手术的患者最早重返运动（9.4±2.1 个月），其次是受伤后 2-6 个月内接受手术的患者（9.9±1.9 个月），最后是受伤后 6 个月以上接受手术的患者（10.9±2.1 个月；p=0.04）。
结论
与年龄较大的运动员（>25 岁）相比，<25 岁的运动员重返运动的比例更高。BPTB 移植物重建 ACL 与腘绳肌腱移植物重建 ACL 相比，重返运动的比例更高，时间更早。如果在受伤后 2-6 个月内进行手术，重返运动的比例最高。
证据等级
III 级。
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