Britt Elise, Ouillette Ryan, Edmonds Eric, Chambers Henry, Johnson Kristina, Bastrom Tracey, Pennock Andrew
Department of Orthopedic Surgery, University of California, San Diego, San Diego, California, USA.
Pediatric Orthopedics and Scoliosis Center, Rady Children's Hospital, San Diego, California, USA.
Orthop J Sports Med. 2020 Nov 30;8(11):2325967120964884. doi: 10.1177/2325967120964884. eCollection 2020 Nov.
Although anterior cruciate ligament (ACL) injuries are common in female soccer players, the optimal graft option for ACL reconstruction is currently unclear.
PURPOSE/HYPOTHESIS: To compare the outcomes of female soccer players after ACL reconstruction using either hamstring tendon autograft or bone-patellar tendon-bone (BTB) autograft. We hypothesized that there would be no difference in clinical outcome scores, return to sport, or retear rates between BTB and hamstring grafts in our study cohort.
Case series; Level of evidence, 4.
We performed a retrospective review of all skeletally mature adolescent female soccer players who underwent primary ACL reconstruction using either hamstring tendon or BTB autograft between 2013 and 2016. Demographic, injury, and surgical variables were documented. Outcome measures included the Lysholm score, Single Assessment Numeric Evaluation, Tegner activity score, and visual analog scales for pain and for satisfaction, as well as ability to return to sport.
Overall, 90 female soccer players met the inclusion criteria, of whom 79% (41 BTB and 30 hamstring) were available for a minimum 2-year follow-up or had a graft failure before the follow-up. The BTB group had a lower body mass index (mean ± SD, 23 ± 3 vs 25 ± 4; = .02) and shorter postoperative follow-up time in months (mean ± SD, 37.4 vs 46.1; ≤ .001); otherwise, no differences in demographic, injury, or surgical variables between groups were noted. Regarding outcome measures, the BTB group achieved a higher Tegner score (6.0 vs 4.2; = .004), and there was no other difference between groups. Of the patients who did not return to soccer, 44.7% reported fear as the reason. Of the patients who did return to soccer, 31.9% sustained another ACL injury (retear or contralateral tear), with no differences in reinjury rates based on graft selection.
Adolescent female soccer players undergoing ACL reconstruction had relatively high satisfaction and outcome scores independent of autograft choice. Notwithstanding, patients and families need to be counseled that less than half of patients will return to their preinjury level of sport and, if an athlete attempts to return, there is a high risk of further ACL injury.
尽管前交叉韧带（ACL）损伤在女子足球运动员中很常见，但目前ACL重建的最佳移植物选择尚不清楚。
目的/假设：比较使用腘绳肌腱自体移植物或髌腱-骨（BTB）自体移植物进行ACL重建后女子足球运动员的结果。我们假设在我们的研究队列中，BTB移植物和腘绳肌移植物在临床结果评分、恢复运动或再撕裂率方面没有差异。
病例系列；证据等级，4级。
我们对2013年至2016年间所有接受了使用腘绳肌腱或BTB自体移植物进行初次ACL重建的骨骼成熟的青少年女子足球运动员进行了回顾性研究。记录了人口统计学、损伤和手术变量。结果指标包括Lysholm评分、单项评估数字评价、Tegner活动评分以及疼痛和满意度的视觉模拟量表，以及恢复运动的能力。
总体而言，90名女子足球运动员符合纳入标准，其中79%（41例BTB和30例腘绳肌）至少有2年的随访资料或在随访前出现移植物失败。BTB组的体重指数较低（均值±标准差，23±3 vs 25±4；P = 0.02），术后随访时间较短（均值±标准差，37.4个月 vs 46.1个月；P≤0.001）；除此之外，两组在人口统计学、损伤或手术变量方面没有差异。关于结果指标，BTB组的Tegner评分较高（6.0 vs 4.2；P = 0.004），两组之间没有其他差异。在未恢复足球运动的患者中，44.7%报告原因是恐惧。在恢复足球运动的患者中，31.9%再次发生ACL损伤（再撕裂或对侧撕裂），基于移植物选择的再损伤率没有差异。
接受ACL重建的青少年女子足球运动员无论自体移植物选择如何，满意度和结果评分相对较高。尽管如此，仍需向患者及其家属提供咨询，不到一半的患者将恢复到受伤前的运动水平，如果运动员试图恢复运动，再次发生ACL损伤的风险很高。
