Ohsawa Takashi, Kimura Masashi, Chikuda Hirotaka
Department of Orthopaedic Surgery, Kiryu Orthopaedic Hospital, 284-1, Ainoshima, Hirosawa-machi, Kiryu City, Gunma, Japan.
Department of Orthopaedic Surgery, Zenshukai Hospital, Maebashi, Japan.
Knee Surg Sports Traumatol Arthrosc. 2021 Apr;29(4):1128-1136. doi: 10.1007/s00167-020-06111-4. Epub 2020 Jun 27.
The present study evaluated the rate of returning to the preinjury level of competitive sports after ACLR and influential factors.
After excluding composite ligament injury cases, 96 patients with a Tegner activity score of ≥ 6 who were managed between April 2015 and March 2016 and had been followed for ≥ 2 years were included in the present study. The patients were evaluated for instability, and the following data were collected: second-look arthroscopy findings, muscle strength, and International Knee Documentation Committee (IKDC) subjective score (follow-up rate: 88.1%).
The rate of returning to the preinjury level of competitive sports was 62/96 (64.6%). Only the total IKDC subjective score (odds ratio, 1.052; 95% confidence interval 1.004-1.102; p = 0.035) and the subjectively evaluated item about giving way (odds ratio, 1.762; 95% confidence interval 1.066-2.911; p = 0.027) were independently associated with the returning to the preinjury level of competitive sports after ACLR in the logistic regression analysis.
The rate of returning to the preinjury level of competitive sports after ACLR was 64.6%, even if a good knee stability and healing status of the sutured meniscus were acquired after ACLR. The IKDC subjective score, especially the item about giving way, was significantly associated with the returning to the preinjury level of competitive sports. The factors assessed by patient-reported evaluations concerning giving way that may be related to functional performance, including brain activity, are important to consider to improve the rate of returning to the preinjury level of competitive sports.
III.
本研究评估了前交叉韧带重建术后恢复到伤前竞技运动水平的比例及影响因素。
排除复合韧带损伤病例后，纳入2015年4月至2016年3月间治疗的、Tegner活动评分≥6且随访≥2年的96例患者。对患者进行不稳定评估，并收集以下数据：二次关节镜检查结果、肌肉力量和国际膝关节文献委员会（IKDC）主观评分（随访率：88.1%）。
恢复到伤前竞技运动水平的比例为62/96（64.6%）。在逻辑回归分析中，仅IKDC主观评分总分（比值比，1.052；95%置信区间1.004 - 1.102；p = 0.035）和关于打软腿的主观评估项目（比值比，1.762；95%置信区间1.066 - 2.911；p = 0.027）与前交叉韧带重建术后恢复到伤前竞技运动水平独立相关。
即使前交叉韧带重建术后获得了良好的膝关节稳定性和缝合半月板的愈合状态，恢复到伤前竞技运动水平的比例仍为64.6%。IKDC主观评分，尤其是关于打软腿的项目，与恢复到伤前竞技运动水平显著相关。患者报告的关于可能与功能表现相关的打软腿的评估所涉及的因素，包括大脑活动，对于提高恢复到伤前竞技运动水平的比例很重要，值得考虑。
III级
