Research Unit for Orthopaedic Sports Medicine and Injury Prevention, ISAG, UMIT Tirol, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.
Department of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Knee Surg Sports Traumatol Arthrosc. 2021 Jun;29(6):1805-1812. doi: 10.1007/s00167-020-06234-8. Epub 2020 Aug 17.
To analyse the effects of graft selection, sex, injury complexity and time to return to competition on the odds to suffer secondary ACL injury (either re-rupture or contralateral ACL tear) in professional alpine skiers.
The database of a specialised joint surgery clinic was screened for professional alpine skiers who had participated in competitions at the FIS race, European Cup and World Cup level prior to having to undergo a primary ACL reconstruction, and who had returned to the same competitional level at least one year prior to the end of the observation period. The rates of secondary ACL injuries were statistically compared between athletes with hamstring and quadriceps tendon autografts, men and women, simple and complex (involvement of menisci or cartilage) primary ACL injuries, and between early (≤ 300 days after primary reconstruction) and late (> 300 days) returners to competition.
Fourteen out of the 30 athletes included (46.7%) suffered secondary ACL injuries on average 29.4 ± 22.5 months after primary reconstruction. The secondary injuries comprised five re-ruptures (16.7%) and nine contralateral ACL tears (30.0%). The odds to suffer contralateral ACL tears were non-significantly higher in patients with hamstring tendon autografts (OR 5.69, n.s.) and in those whose primary injuries were classified as simple ACL tears (OR 5.31, n.s.). None of the factors assessed was associated with the odds of graft failure.
The odds of ACL-injured professional alpine ski racers to suffer secondary ACL tears are nearly 50%, with subsequent contralateral ACL injuries being more common than graft failures. While statistical significance could not be established due to a lack of power, greater odds of contralateral ACL tears were observed in athletes with hamstring tendon grafts as well as those with simple primary ACL injuries. No factors potentially predisposing athletes for graft failure could be identified.
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分析移植物选择、性别、损伤复杂性和重返比赛时间对专业高山滑雪运动员继发 ACL 损伤（再断裂或对侧 ACL 撕裂）的几率的影响。
筛选出在接受初次 ACL 重建之前参加过 FIS 比赛、欧洲杯和世界杯的专业高山滑雪运动员的专门关节外科诊所数据库，并且在观察期结束前至少一年回到同一竞技水平。对采用腘绳肌腱和四头肌腱自体移植物、男性和女性、单纯（半月板或软骨损伤）和复杂（半月板或软骨损伤）初次 ACL 损伤的运动员以及早期（初次重建后≤300 天）和晚期（＞300 天）重返比赛的运动员的继发 ACL 损伤发生率进行统计学比较。
30 名运动员中有 14 名（46.7%）在初次重建后平均 29.4±22.5 个月时发生继发 ACL 损伤。继发性损伤包括 5 例再断裂（16.7%）和 9 例对侧 ACL 撕裂（30.0%）。采用腘绳肌腱自体移植物的患者（OR 5.69，n.s.）和初次损伤为单纯 ACL 撕裂的患者（OR 5.31，n.s.）发生对侧 ACL 撕裂的几率非显著更高。评估的任何因素均与移植物失败的几率无关。
ACL 损伤的专业高山滑雪运动员继发 ACL 撕裂的几率接近 50%，随后对侧 ACL 损伤比移植物失败更常见。由于缺乏效力，尽管未达到统计学意义，但观察到采用腘绳肌腱移植物和初次 ACL 损伤单纯的运动员发生对侧 ACL 撕裂的几率更大。未确定可能使运动员易发生移植物失败的因素。
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